{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:28:46Z","timestamp":1790839726754,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T00:00:00Z","timestamp":1552003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T00:00:00Z","timestamp":1552003200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Coronal alignment of the knee is defined by the hip\u2013knee\u2013ankle angle (HKA), the femoral mechanical angle (FMA), the tibial mechanical angle (TMA), and the joint line convergence angle (JLCA). To date, there is still a lack of knowledge about the variability of native coronal knee alignment. The purpose of this paper is to present a systematic review of the current literature about the variability of coronal knee alignment (HKA, FMA, TMA, and JLCA) in non\u2010osteoarthritic knees.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The electronic databases MEDLINE, EMBASE, and Google Scholar were searched from database inception to search date (November 1, 2018) and screened for relevant studies. The PRISMA guidelines were followed. Inclusion criteria were studies that reported the coronal alignment of the native, non\u2010osteoarthritic knee.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 15 studies met the inclusion criteria. Thirteen studies performed the measurements on weight\u2010bearing long\u2010leg standing radiographs (LLR), one study used MRI, and one study used the EOS imaging system. The mean HKA ranged from 176.7\u00b0 \u00b1 2.8\u00b0 (male) to 180.7\u00b0 (female). The mean FMA ranged from 92.08\u00b0 \u00b1 1.78\u00b0 (female) to 97.2\u00b0 \u00b1 2.7\u00b0 (female). The mean TMA ranged from 84.6\u00b0 \u00b1 2.5\u00b0 (female) to 89.6\u00b0 (female). The mean JLCA ranged from \u2212\u20090.47\u00b0 \u00b1 0.98\u00b0 (male) to \u2212\u20091.9\u00b0 \u00b1 1.4\u00b0 (female).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This systematic review provides a detailed overview about the variability of the coronal knee alignment in non\u2010osteoarthritic knees. The broad variability of all coronal alignment parameters highlights the necessity for a more anatomic and individualized approach in knee arthroplasty. It also offers the fundament to understand the changes in osteoarthritic knees.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of clinical evidence<\/jats:title><jats:p>Systematic review, Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-019-05417-2","type":"journal-article","created":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T05:51:24Z","timestamp":1552024284000},"page":"1359-1367","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Native non\u2010osteoarthritic knees have a highly variable coronal alignment: a systematic review"],"prefix":"10.1002","volume":"27","author":[{"given":"Lukas B.","family":"Moser","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Baselland (Bruderholz, Liestal, Laufen) 4101 Bruderholz Switzerland"},{"name":"<!--<label>2<\/label>--> University of Basel Basel 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T.","family":"Hirschmann","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Baselland (Bruderholz, Liestal, Laufen) 4101 Bruderholz Switzerland"},{"name":"<!--<label>2<\/label>--> University of Basel Basel 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December 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 February 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 March 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"All authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was not required as this is a pure review of the literature not involving humans nor animals.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}