{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:20:54Z","timestamp":1782519654371,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,10,6]],"date-time":"2016-10-06T00:00:00Z","timestamp":1475712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,10,6]],"date-time":"2016-10-06T00:00:00Z","timestamp":1475712000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"name":"None"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of this study was to assess the kinematics of arthritic knees prior to TKA. The hypothesis was that the arthritic knee follows distinct patterns with regard to deformity in coronal plane as it flexes from extended position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Data from 585 consecutive arthritic knees that had undergone TKA using two non\u2010image\u2010based navigation systems were included in the study. Coronal plane alignment given by the femoro\u2010tibial mechanical angle (FTMA) was recorded in extension, 30\u00b0, 60\u00b0, 90\u00b0 and maximum flexion prior to making any bony cuts or ligamentous releases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Complete data were available for 512 (87.5 %) of arthritic knees. It was found that pre\u2010implant arthritic knees behaved in different distinct patterns from full extension to 90\u00b0 flexion. These patterns in FTMA from extension through to 90\u00b0 of flexion were classified into 4\u00a0major types (1, 2, 3, and 4) and 8 subgroups (1A, 1B, 2A, 2B, 3, 4A, 4B, 4C) for varus and valgus knees. Beyond 90\u00b0 of flexion, there were no distinct or consistent patterns. There were differences between varus and valgus knee deformities not only in overall numbers (73.8 % varus vs. 21.1 % valgus) but also in kinematic behaviour. Only 14.1 % of total knees had a consistent deformity (Type 1A) which remained the same throughout the range of flexion. 14.1 % knees actually become opposite deformity as the knee flexes; thus, varus becomes valgus and valgus becomes varus as the knee flexes (Type 3 and 4C).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study has observed and categorised distinct patterns which arthritic knees follow in the coronal plane as it flexes. This dynamic change during flexion will have bearing on collateral releases that are traditionally done based on deformity in extension or 90\u00b0 flexion mainly. This may be the underlying cause of flexion instability especially for Types 3 and 4C knees if collateral soft tissue release is done based on deformity in extension. Full significance of this remains unknown and will need further investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-016-4338-0","type":"journal-article","created":{"date-parts":[[2016,10,6]],"date-time":"2016-10-06T09:20:18Z","timestamp":1475745618000},"page":"3575-3583","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Dynamic knee behaviour: does the knee deformity change as it is flexed\u2014an assessment and classification with computer navigation"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2268-9940","authenticated-orcid":false,"given":"Kamal","family":"Deep","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Golden Jubilee National Hospital Agamemnon Street, Clydebank G81 4DY Glasgow 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