{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:47:02Z","timestamp":1791953222478,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T00:00:00Z","timestamp":1751155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>While bony alignment phenotype reconstruction became an important part of personalised knee arthroplasty, the knowledge on laxity phenotypes (LPs) is still limited. This study aimed to calculate individual LPs and assess their changes based on bony decisions from different alignment workflows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Radiographs and computer\u2010assisted surgery data of 86 knees were imported into a validated knee alignment simulator. Individual bony parameters (medial proximal tibial angle, lateral distal femoral angle and posterior condyle axis) were first introduced. By that, the patient\u2010specific bony phenotype (B\u2010FKP) was implemented, and based on these simulations, the patient\u2010specific laxity phenotype (L\u2010FKP) was defined, calculated and analysed for the total group, as well as for all Coronal Plane Alignment of the Knee (CPAK) subgroups. CPAK I and IV were summarised as varus group; II and V as neutral, and III, VI and IX as valgus group. Identical calculations were then compared for the MA and L\u2010FKP of both workflows. LP was calculated in both extension (L\u2010FKPext) and flexion (L\u2010FKPflex), and a pattern matrix was constructed for all possible L\u2010FKP combinations, enabling a comprehensive distribution analysis. Statistical differences between subgroups and B\u2010FKP and mechanical alignment (MA) workflows were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>B\u2010FKP showed a minimal, non\u2010significant difference for L\u2010FKPext in all subgroups; however, a huge variability in L\u2010FKP pattern analysis. In contrast, MA showed a significant difference for L\u2010FKPext in all subgroups, with a high correlation between L\u2010FKPext and hip\u2013knee\u2013ankle angle. While in MA, 98% of knees showed lateral laxity (L\u2010FKPflex\u2010latlax), in B\u2010FKP, only 56% were L\u2010FKPflex\u2010latlax, with a large variability (31% L\u2010FKPflex\u2010neutr and 13% L\u2010FKPflex\u2010medlax).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Personalised bony resections reduce gap differences for LPext and LPflex independent of the deformity. MA showed a high correlation between deformity and LPext in extension and a uniform lateral laxity in flexion. L\u2010FKP analysis can help to understand the individuality of knees from a soft tissue aspect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.12730","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T02:35:30Z","timestamp":1751250930000},"page":"3637-3645","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Bony alignment decisions affect patient\u2010specific laxity phenotype patterns significantly, independent of the deformity"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6095-3186","authenticated-orcid":false,"given":"Heiko","family":"Graichen","sequence":"first","affiliation":[{"name":"Department of Personalised Orthopaedics (PersO) Privatklinik Siloah Muri bei Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George M.","family":"Avram","sequence":"additional","affiliation":[{"name":"University Clinic of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland Bruderholz Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Zambianchi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Azienda Ospedaliero\u2010Universitaria di Modena University of Modena and Reggio\u2010Emilia Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas M.","family":"Graichen","sequence":"additional","affiliation":[{"name":"Department of Medicine Sigmund Freud University Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Catani","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Azienda Ospedaliero\u2010Universitaria di Modena University of Modena and Reggio\u2010Emilia Modena Italy"},{"name":"Orthopaedic Surgery Department University of Pittsburgh Medical School Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Lustig","sequence":"additional","affiliation":[{"name":"Orthopaedic Department Lyon North University Hospital, H\u00f4pital de La Croix Rousse, Hospices Civils de Lyon Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Hirschmann","sequence":"additional","affiliation":[{"name":"University Clinic of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland Bruderholz Switzerland"},{"name":"Department of Clinical Research, Research Group Michael T. Hirschmann, Regenerative Medicine &amp; Biomechanics University of Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-1119-9"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12082"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-07088-y"},{"key":"e_1_2_11_5_1","unstructured":"European Medicines Agency. 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