{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T16:26:58Z","timestamp":1771864018381,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T00:00:00Z","timestamp":1642636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To analyze the incidence of intraoperative mid\u2010flexion laxity using continuous flexion\u2010arc gap assessment, risk factors for mid\u2010flexion laxity, and clinical results in navigation\u2010assisted total knee arthroplasty (TKA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ninety posterior\u2010stabilized TKAs were performed under navigation guidance for patients with degenerative arthritis and varus deformity. Intraoperatively, the gap between the trial femoral component and insert was evaluated in the navigation system with continuous flexion\u2010arc gap assessment. Each medial and lateral gap at flexion (90\u00b0) and extension (0\u00b0) were made to be less than 3\u00a0mm. Mid\u2010flexion laxity was determined when the gap in the flexion range between 15\u00b0 and 60\u00b0 was 3\u00a0mm or more. The proportion of knees with mid\u2010flexion laxity was investigated. The factors affecting mid\u2010flexion laxity were identified in terms of demographics, preoperative convergence angle, and change in joint line height and posterior femoral offset. The Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 31 cases (34.4%) of lateral mid\u2010flexion laxity (average peak mid\u2010flexion gap\u2009=\u20093.7\u00a0mm). The other 59 cases did not show mid\u2010flexion laxity. The preoperative convergence angle was the only significant factor affecting lateral mid\u2010flexion laxity (odds ratio\u2009=\u20091.466, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). There were no significant differences in the clinical results between the groups with and without mid\u2010flexion laxity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The continuous flexion\u2010arc gap assessment was useful in evaluating mid\u2010flexion laxity using navigation\u2010assisted TKA. The preoperative convergence angle, reflecting soft\u2010tissue laxity, can be a practical and simple radiographic finding for predicting lateral mid\u2010flexion laxity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06846-8","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T19:03:46Z","timestamp":1642619026000},"page":"1307-1315","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Mid\u2010flexion laxity could be identified with continuous flexion\u2010arc gap assessment in patients with a large preoperative convergence angle"],"prefix":"10.1002","volume":"31","author":[{"given":"Sang Jun","family":"Song","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, College of Medicine Kyung Hee University 23 Kyunghee\u2010daero, Dongdaemun\u2010gu 130\u2010872 Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Woo","family":"Lee","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, College of Medicine Kyung Hee University 23 Kyunghee\u2010daero, Dongdaemun\u2010gu 130\u2010872 Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dae Kyung","family":"Bae","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Seoul Sacred Heart General Hospital Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8297-6872","authenticated-orcid":false,"given":"Cheol Hee","family":"Park","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, College of Medicine Kyung Hee University 23 Kyunghee\u2010daero, Dongdaemun\u2010gu 130\u2010872 Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,1,20]]},"reference":[{"key":"e_1_2_8_2_2","unstructured":"ArnoutN VictorJ ChevalierA BellemansJ VerstraeteMAMuscle loaded stability reflects ligament\u2010based stability in TKA: a cadaveric study.Knee Surg Sports Traumatol Arthrosc(2020)10.1007\/s00167\u2010020\u201006329\u2010233165634"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010020\u201005995\u20106"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.06.030"},{"key":"e_1_2_8_5_2","unstructured":"BRAINLAB.KNEE3 SURGICAL TECHNIQUE.2016.https:\/\/www.brainlab.com\/wp\u2010content\/uploads\/2016\/12\/Knee3\u2010Surgical\u2010Technique.pdf. 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