{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:47:59Z","timestamp":1786978079911,"version":"build-2736575974"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T00:00:00Z","timestamp":1748131200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This study investigated the impact of changes in weight\u2010bearing line following open\u2010wedge high tibial osteotomy (HTO) on muscle activation within the lower limb kinetic chain in patients with medial knee osteoarthritis (KOA). A cohort study was conducted with 21 patients diagnosed with KOA who underwent HTO. Three\u2010dimensional gait analysis and surface electromyography were performed preoperatively and at 6 and 12 months postoperatively. Seven lower limb muscles were assessed for co\u2010contraction index, integrated electromyography, root mean square, duration, and SMA during the stance phase. Intragroup and intergroup comparisons were made using one\u2010way and repeated\u2010measures analysis of variance. Preoperatively, the co\u2010contraction indices of the vastus medialis\u2013biceps femoris and vastus medialis\u2013gastrocnemius were significantly higher compared with other muscle pairs (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), but these indices decreased significantly at 6 and 12 months postoperatively (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). The integrated electromyography and root mean square values for six muscles, excluding the vastus lateralis, significantly increased at 6 months postsurgery (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). At 12 months, the root mean square value of the vastus lateralis decreased significantly compared with preoperative levels (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). The gluteus medius and vastus medialis showed significant increases in integrated electromyography, root mean square, and duration of muscle activation at 12 months postoperatively, along with earlier muscle activation timing (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05). The vastus medialis demonstrated improved activation compared with preoperative levels. HTO reduces co\u2010contraction indices, enhances muscle activation, and improves lower limb muscle coordination within 1 year postoperatively.\n                  <\/jats:p>","DOI":"10.1002\/jor.26110","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T06:14:44Z","timestamp":1748153684000},"page":"1454-1462","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Open High Tibial Osteotomy Alters Lower Limb Muscle Activation During Gait Stance Phase"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9040-7464","authenticated-orcid":false,"given":"Jie","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine Capital Medical University Beijing China"},{"name":"Department of the Second Orthopaedics Rehabilitation Centre Beijing Rehabilitation Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hujun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Beijing Rehabilitation Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuling","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of the Second Orthopaedics Rehabilitation Centre Beijing Rehabilitation Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongqing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of the Second Orthopaedics Rehabilitation Centre Beijing Rehabilitation Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenglong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of the Second Orthopaedics Rehabilitation Centre Beijing Rehabilitation Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6832-0789","authenticated-orcid":false,"given":"Kemin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine Capital Medical University Beijing China"},{"name":"Department of Orthopaedics and Rehabilitation China Rehabilitation Research Centre, Beijing Bo'ai Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2023.04.015"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.14022"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23688"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2008.12.003"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2008.12.007"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04587-w"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.25122\/jml-2023-0087"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22608"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12944"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.20326"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200206000-00021"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e31818a8c91"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2020.06.002"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2013.07.008"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2005.07.014"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2014.01.038"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2019.02.798"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2023.106105"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2017.05.023"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2013.12.007"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1247752"},{"issue":"11","key":"e_1_2_11_23_1","first-page":"1454","article-title":"Osteotomy for Medial Compartment Arthritis of the Knee Using a Closing Wedge or An Opening Wedge Controlled by a Puddu Plate. 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