{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T15:40:01Z","timestamp":1760888401347},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2010,1,7]],"date-time":"2010-01-07T00:00:00Z","timestamp":1262822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The effects of osteophyte debridement, bony cuts, and soft tissue releases on the functional flexion axis of the knee can be assessed by evaluating 3D kinematics following each step of a total knee arthroplasty. Using a navigated knee system with dedicated software, the functional flexion axis (helical axis) can be determined after each step. Five paired fresh\u2010frozen cadaveric knees were used with a CT scan performed on each specimen identifying implanted fiducial markers. Kinematics data were recorded during each step of sequential osseous cuts and soft tissue releases for both an unloaded and loaded limb by each of three surgeons. The functional helical (flexion\/extension) axis was identified for all specimens. The internal\/external rotation angle (\u03b8) of the helical axis differed from the transepicondylar axis by \u22128.3\u00b0 to +6.7\u00b0 for the unloaded condition. \u03b8 ranged from \u22127.2\u00b0 to +7.4\u00b0 with distraction. Soft tissue releases had no effect on \u03b8; until a bony cut of the articular surface, which increased \u03b8 from \u22120.3\u00b0 to +9.7\u00b0. Implantation of cruciate retaining prosthetic components subsequently reduced the \u03b8 range \u22127.3\u00b0 to +4.0\u00b0. Thus, soft tissue releases had minimal effect on \u03b8 of the helical axis except for resection of the proximal tibia. Implantation of the CR prosthesis reduced \u00e8 close to that of the intact knee. In a minority of knees, the helical axis did not coincide exactly with the transepicondylar axis. Interspecimen and left\/right variability of \u03b8 were significant, although interinvestigator variability and an applied distraction force were insignificant. \u00a9 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. 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