J Knee Surg 2023; 36(08): 866-872
DOI: 10.1055/s-0042-1744192
Original Article

The “Wind Surf” Deformity—Correcting Fixed Flexion Deformity and Hyperextension in Bilateral CAS TKA

1   Joint Replacement Unit, Fortis Hospital, Jaipur, Rajasthan, India
,
Neil P. Sheth
2   Department of Orthopaedic Surgery, University of Pennysylvania, Philadelphia, Pennsylvania
,
Piyush Agarwal
1   Joint Replacement Unit, Fortis Hospital, Jaipur, Rajasthan, India
,
Mukesh Aswal
1   Joint Replacement Unit, Fortis Hospital, Jaipur, Rajasthan, India
,
Mudit Srivastava
1   Joint Replacement Unit, Fortis Hospital, Jaipur, Rajasthan, India
› Author Affiliations

Abstract

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 “wind surf” deformity mimicking the opposite pull of the wind and a surfer. The incidence of “wind surf” 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° to 20° on one knee and recurvatum of −5° to −20° on the contralateral knee. Additional bone resection and soft-tissue releases were performed for the FFD with a goal to maintain residual 1° to 3° of flexion. Minimal bone resection and soft-tissue disruption were performed on the knee with hyperextension with a goal to maintain 5° to 7° of flexion. These opposite strategies applied with the help of CAS prevented recurrence resulting in satisfactory clinical results at 2-year follow-up. The “wind surf” deformity variant should be identified in patients presenting with severe knee arthritis to guide surgical treatment, prevent recurrence, and obtain favorable clinical patient outcomes.



Publication History

Received: 07 March 2021

Accepted: 25 January 2022

Article published online:
08 March 2022

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