ArticleJournal of orthopaedic case reports2026
Stepwise Surgical Correction of Fixed Flexion Deformity in Total Knee Arthroplasty: Functional Outcomes.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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. Materials and Methods: In this prospective observational study, 55 knees (mean age 57.28 ± 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). Results: The mean pre-operative FFD of 23.04° 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 < 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. Conclusion: 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.
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