Could a simple electrical boost improve posture after knee surgery?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age between 40 and 80 years * Diagnosis of primary knee osteoarthritis scheduled for total knee arthroplasty * Radiographic evidence of Kellgren-Lawrence grade 3-4 knee osteoarthritis * Preoperative knee flexion contracture ≥ 5° * Measurable spinopelvic malalignment, defined as meeting at least one of the following criteria: pelvic tilt (PT) \> 20°, sagittal vertical axis (SVA) \> 50 mm, or lumbar lordosis (LL) \< 40° * IIntact cognitive function based on clinical judgment, sufficient to understand and follow verbal commands, cooperate with the rehabilitation program, and reliably comply with functional assessment procedures * Provision of written informed consent * Able to stand independently and undergo standing lateral radiography Exclusion Criteria: * Prior lumbar or thoracic spinal surgery * History of hip arthroplasty * Prior knee arthroplasty (revision arthroplasty patients) * Active inflammatory arthritis (e.g., rheumatoid arthritis, psoriatic arthritis) * Neurological disease, including stroke, Parkinson's disease, peripheral neuropathy, or spinal cord pathology * Contraindications to NMES, including active cardiac pacemaker, implanted defibrillator, deep vein thrombosis, skin integrity impairment, malignancy, or epilepsy * Severe hip osteoarthritis or other lower extremity pathology significantly affecting spinopelvic alignment (e.g., leg length discrepancy, developmental hip dysplasia, contracture) * Inability to complete the standard rehabilitation protocol due to postoperative complications * Osteoporotic vertebral fracture or significant osteoporosis (T-score \< -2.5 at L1-L4) * Active treatment for malignancy * Psychiatric or medical condition that would prevent completion of the follow-up period * General contraindications to exercise