Knee kinesiography in 2026: Current and future applications for digital orthopaedics and personalised total knee arthroplasty: A narrative review.

Knee Kinesiography, using the KneeKG system, delivers clinically feasible, weight-bearing (WB) three-dimensional knee kinematics and is shifting total knee arthroplasty (TKA) from static templating to function-focused personalisation. This narrative review synthesises how KneeKG applications changed pre- and postoperative care and how these changes can translate into better patient outcomes. Preoperatively, KneeKG quantifies dynamic alignment, varus thrust, dynamic flexion contracture, pivot pattern, tibiofemoral translation, and tibial rotation during gait, defining a functional profile that relates to symptoms and can inform alignment philosophy, bearing selection, and soft-tissue strategy. When coupled with navigation or robotics, these data allow the anticipation of mid-flexion balance requirements while enabling surgeons to set functional targets more likely to yield natural, stable knee in WB condition. A KneeKG-guided prehabilitation pathway also facilitates the recalibration of expectations before surgery and can improve early patient-reported outcomes. Postoperatively, KneeKG audits whether intraoperative parameters (e.g., achieved gaps, implant components, etc.) translate into the intended dynamic behaviour, verifies bearing-intended pivot during WB tasks, and reveals modifiable residual deficits-such as persistent thrust, stiff-knee gait, valgus collapse, or excessive external tibial rotation-to target with therapy. Function-focused rehabilitation programmes anchored on a KneeKG exam demonstrated acceleration of recovery, increase in outcome scores, satisfaction, and raise of the proportion of patients reaching a patient acceptable symptom state, with benefits maintained beyond one year in subsets. Across the episode of care, KneeKG provides a common functional language that links preoperative planning, intraoperative execution, and postoperative rehabilitation, allowing teams to iterate from plan to performance and to close the loop between digital precision and real-world function. By operationalizing dynamic information at the point of care, this exam supports surgeons towards more accurate decisions, more predictable execution, and more personalised rehabilitation; ultimately improving patient-centred results after TKA. Level of Evidence: Level V, narrative review.