{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:21:40Z","timestamp":1785763300280,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate the impact of reduced spinopelvic mobility (SM) on knee flexion deformity (KFD) in patients undergoing total knee arthroplasty (TKA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis on 213 patients (271 knees) undergoing robotic\u2010assisted primary TKA was conducted. Sagittal spinopelvic alignment (SSA) parameters\u2014sacral slope (SS), pelvic incidence (PI), and pelvic tilt (PT)\u2014were measured on lateral standing and sitting spinopelvic radiographs. Patients were stratified according to established SM classifications: standing\u2010sitting difference in SS\u2009\u2265\u200910\u00b0 versus\u2009&lt;\u200910\u00b0, PT\u2009\u2265\u200920\u00b0 versus\u2009&lt;\u200920\u00b0, and Dorr's classification (DC). KFD was assessed intraoperatively using a robotic\u2010assisted surgical platform after placement of arrays: first in the native state (KFDb), and again after osteophyte removal and maximum manual correction (KFDa). Correlations between standing\u2010sitting changes in SSAs and KFDb\/KFDa, as well as differences in mean KFDb\/KFDa between SM groups, were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean differences between standing and sitting was 11.3\u00b0 (SD 9.1) for SS and 6.9\u00b0 (SD 9.8) for PT. Based on SM classifications, 129 knees (48%) showed a SS difference\u2009&lt;\u200910\u00b0, 30 knees (11%) a PT difference\u2009\u2265\u200920\u00b0, and DC categorised 131 (48%) as normal, 64 (24%) as stuck standing, 74 (27%) as stuck sitting, and 1% as kyphotic. The mean KFDb and KFDa were 5\u00b0 (SD 6) and 2\u00b0 (SD 2), respectively. No significant correlations were found between standing\u2010sitting changes in SSAs and KFDb or KFDa (correlation coefficients\u2009&lt;\u20090.1 for all). No significant differences in mean KFDb or KFDa were observed across SM classification groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.2 for all).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Spinopelvic mobility does not correlate with intraoperative knee flexion deformity in patients undergoing TKA suggesting that the increased knee flexion found among these patients is a dynamic rather than a permanent compensatory mechanism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70047","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T10:06:44Z","timestamp":1757412404000},"page":"1346-1353","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Reduced spinopelvic mobility does not correlate with knee flexion deformity in patients undergoing total knee arthroplasty"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9848-778X","authenticated-orcid":false,"given":"Lorenz","family":"Pichler","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Trauma\u2010Surgery Medical University of Vienna Vienna Austria"},{"name":"Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin Center for Musculoskeletal Surgery Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rauf","family":"Alizada","sequence":"additional","affiliation":[{"name":"\u00c7ankaya Hospital for Orthopedic Care Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea M. S.","family":"Cordes","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin Berlin Institute of Health (BIH) \u2010 Julius Wolff Institute (JWI) Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerem","family":"Basarir","sequence":"additional","affiliation":[{"name":"\u00c7ankaya Hospital for Orthopedic Care Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7836-5064","authenticated-orcid":false,"given":"Asim","family":"Kayaalp","sequence":"additional","affiliation":[{"name":"\u00c7ankaya Hospital for Orthopedic Care Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4158-3498","authenticated-orcid":false,"given":"Reha","family":"Tandogan","sequence":"additional","affiliation":[{"name":"\u00c7ankaya Hospital for Orthopedic Care Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"issue":"2","key":"e_1_2_12_2_1","article-title":"The Dorr classification for spinopelvic functional safe component positioning in total hip replacement: a primer for all","volume":"3","author":"Bodner RJ","year":"2022","journal-title":"J Orthop Exp Innov"},{"key":"e_1_2_12_3_1","article-title":"Postoperative changes in CPAK\u2010classification do not significantly influence patient\u2010reported outcome measures following conventional or robotic\u2010assisted total knee arthroplasty: a randomised controlled trial","volume":"1","author":"Bollars P","year":"2025","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"e_1_2_12_4_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_12_5_1","first-page":"479","volume-title":"The pediatric spine: principles and practice","author":"Dubousset J","year":"1994"},{"key":"e_1_2_12_6_1","article-title":"Knee\u2010spine syndrome: management dilemma when knee osteoarthritis coexists with spine degeneration","volume":"14","author":"Govil G","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12730"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12115"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-24243-5_12"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2025.02.015"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12066"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05509-z"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jeo2.70052"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-025-04265-w"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10153242"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12774"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2022.11.003"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B2.BJJ-2020-1050.R1"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B1.13389"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-011-1936-x"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2024.08.028"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12643"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.5.200032"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.20221231"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2021.10.006"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v10.i21.7348"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40634-023-00670-4"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-2232-7511"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2021.11.012"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1701447"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.99B1.BJJ-2016-0415.R1"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s007760200092"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ksa.70047","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T11:28:54Z","timestamp":1775388534000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.70047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/ksa.70047"],"URL":"https:\/\/doi.org\/10.1002\/ksa.70047","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,9]]},"assertion":[{"value":"2025-06-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}