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This study presents a subject\u2010specific musculoskeletal modelling framework to investigate ligamentous characteristics and tibiofemoral contact mechanics for subjects having a varus deformity. A cohort of osteoarthritic subjects with varus deformity and undergoing total knee replacement surgery was analyzed in a standing posture. For each subject, musculoskeletal models with subject\u2010specific knee joint anatomy were developed. A Taguchi\u2010based experimental design was implemented to quantify the influence of individual ligament group slack lengths on the varus alignment. Subsequently, subject\u2010specific ligament slack lengths combinations were predicted using a search\u2010based optimisation that minimises the muscle\u2010volume\u2010weighted sum of squared muscle activations. The MCL\u2010G and LCL\u2010G groups were identified as the dominant influencers of varus angles. Optimisation revealed that specific varus alignments were associated with distinct laxity of medial and lateral soft tissue. These ligamentous adjustments corresponded to a significant medial shift in the tibiofemoral contact centre relative to a neutral alignment. Furthermore, higher degrees of varus malalignment correlated with a substantial increase in the mean total knee joint reaction force and a concurrent increase in the knee adduction moment. The proposed framework provides a subject\u2010specific in silico approach for quantifying ligament adaptations and contact forces associated with varus deformity.<\/jats:p>","DOI":"10.1002\/cnm.70223","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:32:46Z","timestamp":1792038766000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Computational Framework for Modelling Subject Specific Changes in Knee Ligaments and Tibiofemoral Contact Associated With Varus Deformity"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6481-843X","authenticated-orcid":false,"given":"Milan","family":"Chandarana","sequence":"first","affiliation":[{"name":"School of Interdisciplinary Research (SIRe), Indian Institute of Technology Delhi  New Delhi 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