{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T12:53:48Z","timestamp":1782392028110,"version":"3.54.5"},"reference-count":44,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Some knee osteoarthritis (KOA) patients show knee flexion in standing despite full extension in supine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined whether sagittal spinopelvic alignment is associated with the discrepancy between supine and standing knee extension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective cross-sectional study, 124 KOA patients undergoing preoperative evaluation were reviewed. Standing sagittal hip\u2013knee\u2013ankle angle (sHKA) was measured on full-length standing lateral radiographs, and supine sHKA was measured with a handheld two-arm goniometer. The difference between standing and supine sHKA (\u0394sHKA) was examined. Patients were classified as having a \u0394sHKA of \u226510\u00b0 or &lt;10\u00b0.Age, sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic tilt, pelvic incidence (PI), and PI\u2013LL were analyzed using multivariable logistic regression and receiver operating characteristic (ROC) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>21 patients (16.9%) had \u0394sHKA \u226510\u00b0. These individuals were older and had larger SVA, pelvic tilt, and PI-LL. PI-LL was associated with \u0394sHKA of \u226510\u00b0 (odds ratio: 1.08; 95% CI: 1.01\u20131.11; p\u2009=\u20090.03). ROC curve showed a PI-LL cutoff of 42.5\u00b0 (AUC: 0.796; sensitivity: 47.6%; specificity: 96.1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Larger PI-LL was associated with standing knee flexion, even in patients with full extension in the supine position. Therefore, sagittal spine alignment should be evaluated in KOA patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538127261430797","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T11:53:21Z","timestamp":1773402801000},"page":"1382-1391","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pelvic incidence\u2013lumbar lordosis mismatch is associated with knee extension discrepancy between the supine and standing positions in patients with knee osteoarthritis"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9717-2834","authenticated-orcid":false,"given":"Ryosuke","family":"Tsutsumi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 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