{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:10:54Z","timestamp":1787645454160,"version":"build-2736575974"},"reference-count":26,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"7","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Increased varus\/valgus laxity and perceived knee instability are independently associated with poor outcomes in people with knee osteoarthritis. However, the relationship between laxity and perceived instability is unclear. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p> To assess whether knee extensor strength, pain, and knee laxity are related to perceived knee instability in patients with advanced knee osteoarthritis. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> This was a secondary analysis of a prospective observational cohort study of 35 patients (24 female; mean \u00b1 SD age, 60 \u00b1 8 years; body mass index, 33 \u00b1 5 kg\/m<jats:sup>2<\/jats:sup>) with knee osteoarthritis awaiting total knee arthroplasty (36 knees). Within 1 month before arthroplasty, we measured isometric knee extension strength and self-reported knee pain (using the Knee injury and Osteoarthritis Outcome Score pain subscale). Patients rated their perception of knee instability as moderate to severe (n = 20) or slight to none (n = 15 patients, n = 16 knees) using the Knee Outcome Survey. We measured intraoperative varus\/valgus knee laxity. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Lower knee extension strength (P = .01) and greater pain (P&lt;.01) were associated with the perception of moderate to severe knee instability. Laxity was not related to perceived knee instability (P = .63). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Knee extension strength and pain were associated with perceived instability in people with advanced osteoarthritis. Varus\/valgus laxity was not related to perceived knee instability. <\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p> Level 2, prognostic. 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