{
  "abstract": "Lower-limb alignment is central to human bipedal locomotion and a key determinant of joint kinematics and osteoarthritis risk in modern clinical practice. However, its significance in hominins, and therefore its evolutionary implications, remain poorly understood. Advances in robotic-assisted total knee arthroplasty (TKA) provide highly precise measurements of lower-limb alignment, joint morphology and soft-tissue balance that can elucidate these understudied aspects of hominin functional morphology. Here, we perform a proof-of-concept robotic-assisted TKA on an anatomically accurate model of the Spy II Neandertal. Using a robotic-assistance system, we registered bony morphology and replicated soft-tissue laxity extrapolated from a modern patient with a comparable alignment phenotype. We confirmed a pronounced constitutional varus alignment, classifying Spy II as a CPAK type I knee. This phenotype resembles that of modern athletes engaged in significant weight-bearing sports or intense physical activity during growth. The demonstration of constitutional varus in a hominin fossil thus suggests a deep evolutionary origin for this alignment pattern in modern humans, contextualizing normal knee variation and supporting an individualized alignment approach to modern TKA.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "name": "Hendrik Pott",
      "orcid": "0009-0003-4584-1524"
    },
    {
      "name": "Peter Savov"
    },
    {
      "name": "Ricarda Stauss"
    },
    {
      "name": "Laura M. Watson"
    },
    {
      "name": "Ottmar Kullmer"
    },
    {
      "name": "Max Ettinger"
    },
    {
      "name": "Nicole M. Webb"
    },
    {
      "name": "Tara Chapman"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1b9epma1jqt3m.bib",
  "cited_by": 0,
  "doi": "10.1038/s41598-026-77544-z",
  "fulltext_url": "https://doi.org/10.1038/s41598-026-77544-z",
  "id": "1b9epma1jqt3m",
  "issns": [
    "2045-2322"
  ],
  "landing_url": "https://www.nature.com/articles/s41598-026-77544-z",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "Q"
    ],
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "3314|Pleistocene-Era Hominins and Archaeology"
    ]
  ],
  "openalex": "W7223550539",
  "pdf_url": "https://www.nature.com/articles/s41598-026-77544-z.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-25",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/1b9epma1jqt3m.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:34Z",
      "native_id": "10.1038/s41598-026-77544-z",
      "source": "crossref",
      "url": "https://www.nature.com/articles/s41598-026-77544-z"
    },
    {
      "first_seen": "2026-10-30T13:45:59Z",
      "native_id": "c628a1097f514deda9ff20422f1e6644",
      "source": "doaj",
      "url": "https://doi.org/10.1038/s41598-026-77544-z"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:R",
      "subfield": "general"
    }
  ],
  "title": "Robotic-assisted knee arthroplasty methods provide insight into Homo neanderthalensis gait and the evolutionary origins of modern human knee variation",
  "title_text": "Robotic-assisted knee arthroplasty methods provide insight into Homo neanderthalensis gait and the evolutionary origins of modern human knee variation",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:59Z",
  "url": "https://research.draconitic.com/paper/1b9epma1jqt3m",
  "venue": "Scientific Reports",
  "versions": []
}