{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T10:51:27Z","timestamp":1776682287214,"version":"3.51.2"},"reference-count":51,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"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."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the impact of static native tibial alignment in total knee arthroplasty (TKA) on whole\u2010body postoperative gait biomechanics, comparing adjusted mechanical alignment (aMA) and inverse kinematic alignment (iKA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty patients undergoing primary TKA were included: 15 in the aMA group (17 knees) and 15 in the iKA group (19 knees), assessed 2 years post\u2010surgery. A healthy control group of 15 participants, matched for age, sex and body mass index (BMI), was included. Postoperative spatiotemporal and kinematic gait parameters were measured using 3D motion capture during gait.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The aMA group demonstrated persistent knee flexion around midstance during the stance phase (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002, &gt;10.00\u00b0), reduced knee flexion at swing onset (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011, \u221212.00\u00b0), and decreased ankle plantarflexion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002, \u22128.00\u00b0). Additionally, the aMA group showed reduced hip extension (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), increased anterior pelvic tilt (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), exaggerated thorax flexion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and altered elbow motion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.015). In contrast, the iKA group exhibited gait patterns more closely resembling healthy controls, with a greater range of motion (ROM) at the hip, knee and ankle, improved ankle and foot progression angles, and no differences in thorax posture or elbow angles compared to controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings underscore the integrated nature of gait biomechanics and suggest that subtle modifications to the knee joint line may contribute to widespread kinematic adaptations. Preserving static native tibial alignment through personalised surgical strategies may, therefore, enhance functional outcomes following TKA.<\/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.70356","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:25:43Z","timestamp":1773005143000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Static native tibial alignment in total knee arthroplasty optimises whole\u2010body gait kinematics"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1985-3321","authenticated-orcid":false,"given":"Zhijun","family":"Li","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Sciences KU Leuven Brugge Belgium"},{"name":"Department of Massachusetts General Hospital Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Winnock de Grave","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences KU Leuven Brugge Belgium"},{"name":"Department of Orthopaedic Surgery AZ Delta Roeselare Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamaya","family":"Van Criekinge","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences KU Leuven Brugge Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Luyckx","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences KU Leuven Brugge Belgium"},{"name":"Department of Orthopaedic Surgery AZ Delta Roeselare Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2794-3071","authenticated-orcid":false,"given":"Kurt","family":"Claeys","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences KU Leuven Brugge Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2019.01.030"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2018.12.013"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-3-4"},{"issue":"4","key":"e_1_2_11_5_1","first-page":"560","article-title":"Gait analysis: clinical facts","volume":"52","author":"Baker R","year":"2016","journal-title":"Eur J Phys Rehabil Med"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.26.BJO-2020-0162.R1"},{"issue":"231","key":"e_1_2_11_7_1","first-page":"2","article-title":"Whole body gait function during stair ascending and level walking in patients following total knee arthroplasty","volume":"2","author":"Behrend H","year":"2014","journal-title":"Int J Phys Med Rehabil"},{"issue":"2","key":"e_1_2_11_8_1","first-page":"353","article-title":"Gait analysis: normal and pathological function","volume":"9","author":"Burnfield M","year":"2010","journal-title":"J Sport Sci Med"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B.BJJ-2020-0940.R1"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4612-4866-8_17"},{"key":"e_1_2_11_11_1","first-page":"511","article-title":"Optimization of walking ability of children with cerebral palsy","volume":"53","author":"Davids JR","year":"2004","journal-title":"Instr Course Lect"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.07.035"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2008.11.011"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0314991"},{"issue":"1","key":"e_1_2_11_15_1","first-page":"246","article-title":"The Eeklo modified subvastus approach for total knee arthroplasty: detailed surgical tips and tricks","volume":"4","author":"Ghijselings I","year":"2021","journal-title":"J Orthop Surg Tech"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmedt.2022.901331"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20080901-16"},{"key":"e_1_2_11_18_1","volume-title":"Human orthopaedic biomechanics: fundamentals, devices and applications","author":"Innocenti B","year":"2022"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2008.10.001"},{"key":"e_1_2_11_20_1","volume-title":"Encyclopedia of computational neuroscience","author":"Jaeger D","year":"2015"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43465-022-00754-w"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-443-10009-3.50005-9"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-013-2701-y"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1310\/sci1301-32"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1123\/jab.2025-0062"},{"key":"e_1_2_11_26_1","first-page":"1","article-title":"Effect of alignment strategy on lower limb kinematics during stair descent after robot\u2010assisted total knee arthroplasty","author":"Li Z","year":"2025","journal-title":"Knee Surg Sport Traumatol Arthrosc"},{"key":"e_1_2_11_27_1","first-page":"1","article-title":"Preserving the native knee joint line obliquity in total knee arthroplasty benefits ankle movement during the five times sit\u2010to\u2010stand test","author":"Li Z","year":"2025","journal-title":"Knee Surg Sport Traumatol Arthrosc"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B2.BJJ-2020-1050.R1"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10195-023-00702-w"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2010.04.005"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.09.031"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2013.02.006"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-4899-1"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9290(01)00105-1"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12927"},{"key":"e_1_2_11_36_1","volume-title":"Gait analysis: normal and pathological function","author":"Perry J","year":"2010"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167-9457(91)90046-Z"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.34.4.279"},{"key":"e_1_2_11_39_1","volume-title":"The knee: a comprehensive review","author":"Scuderi GR","year":"2009"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2008.05.013"},{"key":"e_1_2_11_41_1","first-page":"27","article-title":"MAKO TKA surgical guide","author":"Stryker Corporation","year":"2016","journal-title":"Stryker Robot Arm Syst"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2023.102280"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13051358"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13185623"},{"key":"e_1_2_11_45_1","unstructured":"Vicon Motion Systems. Plug\u2010in gait reference guide. Vicon Nexus; 2020."},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2019.06.002"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.3.180008"},{"issue":"7","key":"e_1_2_11_48_1","first-page":"662","article-title":"A review on the coordinative structure of human walking and the application of principal component analysis","volume":"8","author":"Wang X","year":"2013","journal-title":"Neural Regen Res"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-023-07464-2"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2022.103305"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06165-4"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/72.1.45"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70356","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ksa.70356","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70356","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T09:57:05Z","timestamp":1776679025000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.70356"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":51,"alternative-id":["10.1002\/ksa.70356"],"URL":"https:\/\/doi.org\/10.1002\/ksa.70356","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,24]]},"assertion":[{"value":"2025-11-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ksa.70356"}}