{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:51:43Z","timestamp":1786121503066,"version":"build-2736575974"},"reference-count":0,"publisher":"Indian Orthopaedic Research Group","issue":"7","content-domain":{"domain":["jocr.co.in"],"crossmark-restriction":true},"short-container-title":["Jocr"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>Introduction: Fixed flexion deformity (FFD) in advanced knee osteoarthritis (OA) presents a significant intraoperative challenge during total knee arthroplasty (TKA), primarily due to soft-tissue contractures and bony deformities that impede optimal alignment and functional recovery. This study aims to evaluate the effectiveness of intraoperative correction of FFD and to assess short-term functional outcomes following TKA.\n\nMaterials and Methods: In this prospective observational study, 55 knees (mean age 57.28 \u00b1 9.35 years) with Grade 4 OA and FFD underwent TKA between March 2022 and March 2024. Correction was achieved using graded posterior soft-tissue releases and distal femoral resections. Functional outcomes were assessed at 6 months using the Knee Society Score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).\n\nResults: The mean pre-operative FFD of 23.04\u00b0 was significantly corrected intraoperatively. At 6 months, the mean KSS improved from 51.29 to 81.93, whereas the WOMAC decreased from 80.93 to 20.1 (P &lt; 0.001). Full knee extension was achieved in all cases, with excellent\/good outcomes in 89.08% of patients. No significant differences were observed between primary and secondary OA groups.\n\nConclusion: Systematic intraoperative correction of FFD using algorithm-based soft-tissue release and distal femoral resection during TKA gave reliable deformity correction, excellent functional recovery, and high patient satisfaction in this study. However, longer-term studies with larger sample sizes are needed to confirm the durability of these outcomes.\n\nKeywords: Total knee arthroplasty, fixed flexion deformity, posterior soft-tissue release, distal femoral resection, osteoarthritis, functional outcomes, Western Ontario and McMaster Universities Osteoarthritis Index score, Knee Society score.<\/jats:p>","DOI":"10.13107\/jocr.2026.v16.i07.7716","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T06:40:47Z","timestamp":1783665647000},"page":"444-449","update-policy":"https:\/\/doi.org\/10.13107\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Stepwise Surgical Correction of Fixed Flexion Deformity in Total Knee Arthroplasty: Functional Outcomes"],"prefix":"10.13107","volume":"16","author":[{"given":"Shravan Kumar","family":"Peddamadyam","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aravind Kumar","family":"Bodla","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shravani","family":"Jagadabi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nageswara Rao","family":"Kancherla","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagesh","family":"Cherukuri","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reddy Vamsi Krishna","family":"Arcot","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Fellowship in National Board (FNB) in Arthroplasty at Amandeep Hospital, Amritsar, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5271","published-online":{"date-parts":[[2026]]},"container-title":["Journal of Orthopaedic Case Reports"],"original-title":[],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T04:44:03Z","timestamp":1786077843000},"score":1,"resource":{"primary":{"URL":"https:\/\/jocr.co.in\/wp\/2026\/07\/stepwise-surgical-correction-of-fixed-flexion-deformity-in-total-knee-arthroplasty-functional-outcomes\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026]]},"published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.13107\/jocr.2026.v16.i07.7716","relation":{},"ISSN":["2321-3817"],"issn-type":[{"value":"2321-3817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"Research Article","name":"content_type","label":"Content Type"},{"value":"Yes","name":"crosschecked","label":"CrossChecked"},{"value":"Yes","name":"peer_reviewed","label":"Peer Reviewed"},{"value":"10.13107\/jocr.2026.v16.i07.7716","name":"published","label":"Published"},{"value":"Creative Commons Attribution","name":"license","label":"License","explanation":{"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},"group":{"name":"rights","label":"Rights"}}]}}