{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:31:42Z","timestamp":1780504302931,"version":"3.54.1"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Severe knee arthritis can result in complex coronal and sagittal angular deformities. Windswept deformity is used to describe a varus deformity and contralateral valgus deformity. We recognized a new sagittal pattern at the time of computer-assisted surgery (CAS) in total knee arthroplasty (TKA) in which one knee has a fixed flexion deformity (FFD), while the contralateral knee has a hyperextension deformity. We propose to define it as \u201cwind surf\u201d deformity mimicking the opposite pull of the wind and a surfer. The incidence of \u201cwind surf\u201d deformity in this series was 0.96% among a cohort of 2,291 bilateral TKAs performed between 2013 and 2018. Twenty-two patients were identified with an FFD of 5\u00b0 to 20\u00b0 on one knee and recurvatum of \u22125\u00b0 to \u221220\u00b0 on the contralateral knee. Additional bone resection and soft-tissue releases were performed for the FFD with a goal to maintain residual 1\u00b0 to 3\u00b0 of flexion. Minimal bone resection and soft-tissue disruption were performed on the knee with hyperextension with a goal to maintain 5\u00b0 to 7\u00b0 of flexion. These opposite strategies applied with the help of CAS prevented recurrence resulting in satisfactory clinical results at 2-year follow-up. The \u201cwind surf\u201d deformity variant should be identified in patients presenting with severe knee arthritis to guide surgical treatment, prevent recurrence, and obtain favorable clinical patient outcomes.<\/jats:p>","DOI":"10.1055\/s-0042-1744192","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T00:10:42Z","timestamp":1646784642000},"page":"866-872","source":"Crossref","is-referenced-by-count":1,"title":["The \u201cWind Surf\u201d Deformity\u2014Correcting Fixed Flexion Deformity and Hyperextension in Bilateral CAS TKA"],"prefix":"10.1055","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9414-5344","authenticated-orcid":false,"given":"Anoop","family":"Jhurani","sequence":"additional","affiliation":[{"name":"Joint Replacement Unit, Fortis Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil P.","family":"Sheth","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pennysylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyush","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Joint Replacement Unit, Fortis Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukesh","family":"Aswal","sequence":"additional","affiliation":[{"name":"Joint Replacement Unit, Fortis Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mudit","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Joint Replacement Unit, Fortis Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,3,8]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1136\/adc.58.7.541","article-title":"\u2018Windswept 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Rheumatol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/1471-2474-8-83","article-title":"Reproducibility of goniometric measurement of the knee in the in-hospital phase following total knee arthroplasty","volume":"8","author":"A F Lenssen","year":"2007","journal-title":"BMC Musculoskelet Disord"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1302\/0301-620X.94B5.27211","article-title":"Computer-assisted total knee replacement in patients with arthritis and a recurvatum deformity","volume":"94","author":"A Mullaji","year":"2012","journal-title":"J Bone Joint Surg Br"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1007\/s00264-008-0694-9","article-title":"Measurement of knee joint motion using digital imaging","volume":"33","author":"D Bennett","year":"2009","journal-title":"Int 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