In vivo movement analysis of the patella using a three-dimensional computer model.

We used three-dimensional movement analysis by computer modelling of knee flexion from 0 degrees to 50 degrees in 14 knees in 12 patients with recurrent patellar dislocation and in 15 knees in ten normal control subjects to compare the in vivo three-dimensional movement of the patella. Flexion, tilt and spin of the patella were described in terms of rotation angles from 0 degrees . The location of the patella and the tibial tubercle were evaluated using parameters expressed as percentage patellar shift and percentage tubercle shift. Patellar inclination to the femur was also measured and patellofemoral contact was qualitatively and quantitatively analysed. The patients had greater values of spin from 20 degrees to 50 degrees , while there were no statistically significant differences in flexion and tilt. The patients also had greater percentage patellar shift from 0 degrees to 50 degrees , percentage tubercle shift at 0 degrees and 10 degrees and patellar inclination from 0 degrees to 50 degrees with a smaller oval-shaped contact area from 20 degrees to 50 degrees moving downwards on the lateral facet. Patellar movement analysis using a three-dimensional computer model is useful to clearly demonstrate differences between patients with recurrent dislocation of the patella and normal control subjects.

[1]  William E. Lorensen,et al.  Marching cubes: a high resolution 3D surface construction algorithm , 1996 .

[2]  G. Ramsby,et al.  The evaluation of patellofemoral pain using computerized tomography. A preliminary study. , 1986, Clinical orthopaedics and related research.

[3]  O. Karaoğlan,et al.  Kinematic and dynamic axial computed tomography of the patello-femoral joint in patients with anterior knee pain , 2005, Knee Surgery, Sports Traumatology, Arthroscopy.

[4]  Nomura,et al.  A mid-term follow-up of medial patellofemoral ligament reconstruction using an artificial ligament for recurrent patellar dislocation. , 2000, The Knee.

[5]  L Blankevoort,et al.  Influence of soft structures on patellar three-dimensional tracking. , 1994, Clinical orthopaedics and related research.

[6]  A. C. Merchant,et al.  Roentgenographic analysis of patellofemoral congruence. , 1974, The Journal of bone and joint surgery. American volume.

[7]  William E. Lorensen,et al.  Marching cubes: A high resolution 3D surface construction algorithm , 1987, SIGGRAPH.

[8]  E. Salvati,et al.  Patella position in the normal knee joint. , 1971, Radiology.

[9]  J. Brossmann,et al.  Kinematic CT and MR imaging of the patellofemoral joint , 1999, European Radiology.

[10]  D. Hungerford,et al.  Biomechanics of the patellofemoral joint. , 1979, Clinical orthopaedics and related research.

[11]  Mustafa Harman,et al.  Evaluation of the patellofemoral joint with kinematic MR fluoroscopy. , 2002, Clinical imaging.

[12]  B B Seedhom,et al.  Biomechanics of the patello-femoral joint. Part I: A study of the contact and the congruity of the patello-femoral compartment and movement of the patella. , 1983, Engineering in medicine.

[13]  F G Shellock,et al.  Quantification of patellar tracking using kinematic MRI , 1998, Journal of magnetic resonance imaging : JMRI.

[14]  S. Koskinen,et al.  Scoring of patellofemoral disorders. , 1993, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[15]  R Huiskes,et al.  The three‐dimensional tracking pattern of the human patella , 1990, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[16]  A. Haims,et al.  Morphometric Comparison of the Pedicle Rib Unit to Pedicles in the Thoracic Spine , 2004, Spine.

[17]  Eugene Ozhinsky,et al.  Magnetic resonance imaging of patellofemoral kinematics with weight-bearing. , 2003, The Journal of bone and joint surgery. American volume.

[18]  E. Mcnally,et al.  Assessment of patellar maltracking using combined static and dynamic MRI , 2000, European Radiology.

[19]  Yoshinobu Sato,et al.  Assessment of the three‐dimensional relationship of the ossific nuclei and cartilaginous anlagen in congenital clubfoot by 3‐D MRI , 2005, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[20]  U. Kujala,et al.  Patellofemoral relationships in recurrent patellar dislocation. , 1989, The Journal of bone and joint surgery. British volume.

[21]  Akira Goto,et al.  In vivo three‐dimensional wrist motion analysis using magnetic resonance imaging and volume‐based registration , 2005, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[22]  Hideki Yoshikawa,et al.  Capitate-based kinematics of the midcarpal joint during wrist radioulnar deviation: an in vivo three-dimensional motion analysis. , 2004, The Journal of hand surgery.

[23]  J. Duncan,et al.  Two-dimensional rigid-body kinematics using image contour registration. , 1995, Journal of biomechanics.

[24]  Georges Y. El-Khoury,et al.  Patellofemoral joint motion: Evaluation by ultrafast computed tomography , 2004, Skeletal Radiology.

[25]  F G Shellock,et al.  Patellar tracking abnormalities: clinical experience with kinematic MR imaging in 130 patients. , 1989, Radiology.

[26]  R Nagamine,et al.  Patellar tracking measurement in the normal knee , 1995, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[27]  R. A. Fellows,et al.  Magnetic resonance imaging for in vivo assessment of three-dimensional patellar tracking. , 2005, Journal of biomechanics.

[28]  H Graichen,et al.  A new in vivo technique for determination of 3D kinematics and contact areas of the patello-femoral and tibio-femoral joint. , 2004, Journal of biomechanics.

[29]  P. Maquet.  [Biomechanics of the patello-femoral joint]. , 1978, Acta orthopaedica Belgica.

[30]  F E Zajac,et al.  In vivo tracking of the human patella using cine phase contrast magnetic resonance imaging. , 1999, Journal of biomechanical engineering.

[31]  Yoshinobu Sato,et al.  Kinematics of the Upper Cervical Spine in Rotation: In Vivo Three-Dimensional Analysis , 2004, Spine.

[32]  B. Reider,et al.  Patellar tracking. , 1981, Clinical orthopaedics and related research.

[33]  Masao Akagi,et al.  In Vivo Three-Dimensional Patellar Tracking on the Femur , 2003, Clinical orthopaedics and related research.

[34]  S. Tennant,et al.  Patello-femoral tracking in the weight-bearing knee: a study of asymptomatic volunteers utilising dynamic magnetic resonance imaging: a preliminary report , 2001, Knee Surgery, Sports Traumatology, Arthroscopy.

[35]  S. C. Chen,et al.  The treatment of patellar instability by lateral release. , 1984, The Journal of bone and joint surgery. British volume.

[36]  M Heller,et al.  Patellar tracking patterns during active and passive knee extension: evaluation with motion-triggered cine MR imaging. , 1993, Radiology.

[37]  F G Shellock,et al.  Patellofemoral joint: kinematic MR imaging to assess tracking abnormalities. , 1988, Radiology.

[38]  R Huiskes,et al.  The biomechanics of the human patella during passive knee flexion. , 1995, Journal of biomechanics.

[39]  P. O'Donnell,et al.  Evaluation of patellar tracking in symptomatic and asymptomatic individuals by magnetic resonance imaging , 2005, Skeletal Radiology.

[40]  M. S. Hefzy,et al.  Effects of tibial rotations on patellar tracking and patello-femoral contact areas. , 1992, Journal of biomedical engineering.

[41]  K. Shino,et al.  Subluxation of the patella. Computed tomography analysis of patellofemoral congruence. , 1988, The Journal of bone and joint surgery. American volume.

[42]  F G Shellock,et al.  Kinematic MR imaging of the patellofemoral joint: comparison of passive positioning and active movement techniques. , 1992, Radiology.