{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T13:40:16Z","timestamp":1783690816224,"version":"3.55.0"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"13","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>There is currently a paucity of data regarding the potential relationships between preexisting spinal deformity and clinical outcomes following total knee arthroplasty (TKA). We sought to expand upon this deficit. We hypothesize that lumbar sagittal mismatch deformity (MD) will correlate with a decrease in functional outcomes after TKA. This retrospective cohort comparison of 933 TKAs was performed between January 2017 and 2020. TKAs were excluded if they were not performed for primary osteoarthritis (OA) or if preoperative lumbar radiographs were unavailable\/inadequate to measure sagittal parameters of interest: pelvic incidence, sacral slope, pelvic tilt, lumbar lordosis, and deformity mismatch. Ninety-four TKAs were subsequently available for inclusion and divided into two groups: those with MD as defined by |PI-LL|\u2009&gt;\u200910 degrees and those without MD. The following clinical outcomes were compared between the groups: total postoperative arc of motion (AOM), incidence of flexion contracture, and need for manipulation under anesthesia (MUA). In total, 53 TKAs met the MD criteria, while 41 did not have MD. There were no significant differences in demographics, body mass index, preoperative knee range of motion (ROM), preoperative AOM, or opiate use between the groups. TKAs with MD were more likely to have MUA (p\u2009=\u20090.026), ROM &lt;0 to 120 (p\u2009&lt;\u20090.001), a decreased AOM by 16 degrees (p\u2009&lt;\u20090.001), and a flexion contracture postoperatively (p\u2009=\u20090.01). Preexisting MD may adversely affect clinical results following TKA. Statistically and clinically significant decreases in postoperative ROM\/AOM, increased likelihood of flexion contracture, and increased need for MUA were all noted in those with MD. This is a Level 3 study.<\/jats:p>","DOI":"10.1055\/s-0041-1723979","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:09:37Z","timestamp":1614038977000},"page":"1409-1416","source":"Crossref","is-referenced-by-count":9,"title":["Lumbar Spine Sagittal Mismatch Deformity Negatively Affects Total Knee Arthroplasty Outcomes"],"prefix":"10.1055","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6076-7399","authenticated-orcid":false,"given":"William L.","family":"Sheppard","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3176-1382","authenticated-orcid":false,"given":"Alexander","family":"Upfill-Brown","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin M.","family":"McKay","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard Y.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don Y.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, California"},{"name":"David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam A.","family":"Sassoon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of California, Los Angeles, Santa Monica, California"},{"name":"David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,2,22]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1007\/s11999-016-4787-2","article-title":"Does degenerative lumbar spine disease influence femoroacetabular flexion in patients undergoing total hip arthroplasty?","volume":"474","author":"C I Esposito","year":"2016","journal-title":"Clin Orthop Relat Res"},{"issue":"11","key":"ref2","first-page":"e00133","article-title":"Timing of lumbar spinal fusion affects total hip arthroplasty outcomes","volume":"3","author":"A Bala","year":"2019","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1007\/s11999-010-1236-5","article-title":"Back pain and total hip arthroplasty: a prospective natural history study","volume":"468","author":"J Parvizi","year":"2010","journal-title":"Clin Orthop Relat Res"},{"issue":"19","key":"ref4","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1097\/BRS.0b013e318145a3c5","article-title":"Hip-spine syndrome: the effect of total hip replacement surgery on low back pain in severe osteoarthritis of the hip","volume":"32","author":"P Ben-Galim","year":"2007","journal-title":"Spine"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s00264-019-04363-5","article-title":"How do global sagittal alignment and posture change after total hip arthroplasty?","volume":"44","author":"Y Kim","year":"2020","journal-title":"Int Orthop"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1302\/0301-620X.85B1.13389","article-title":"The knee-spine syndrome. 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