Flexion contracture can cause component mismatch in the Prophecy ® preoperative patient-specific instrumentation for Evolution ® medial-pivot knee system.

Flexion contracture may cause PSI mismatch. Notably, flexion contracture greater than 20° was a significant risk factor for the PSI component match group versus the mismatch group. During preoperative planning for a patient with flexion contracture, surgeons should prepare for the possibility of inserting an undersized tibial component.