Sensitivity of the knee joint kinematics calculation to selection of flexion axes.

Various flexion axes have been used in the literature to describe knee joint kinematics. This study measured the passive knee kinematics of six cadaveric human knee specimens using two widely accepted flexion axes; transepicondylar axis and the geometric center axis. These two axes were found to form an angle of 4.0 degrees +/- 0.8 degrees. The tibial rotation calculated using the transepicondylar axis was significantly different than the rotation obtained using the geometric center axis for the same knee motion. At 90 degrees of flexion, the tibial rotation obtained using the transepicondylar axis was 4.8 degrees +/- 9.4 degrees whereas the rotation recorded using the geometric center axis at the same flexion angle was 13.8 degrees +/- 10.2 degrees. At 150 degrees of knee flexion, the rotations obtained from the transepicondylar and the geometric center axes were 7.2 degrees +/- 5.7 degrees and 19.9 degrees +/- 6.9 degrees, respectively. The data suggest that a clear definition of the flexion axis is necessary when reporting knee joint kinematics.

[1]  Ephrat Most,et al.  Development of a 6-DOF robotic test system for studying the biomechanics of total knee replacement , 2000 .

[2]  Guoan Li,et al.  Femoral Rollback After Cruciate-Retaining and Stabilizing Total Knee Arthroplasty , 2003, Clinical orthopaedics and related research.

[3]  B. Beynnon,et al.  The Transepicondylar Axis Approximates the Optimal Flexion Axis of the Knee , 1998, Clinical orthopaedics and related research.

[4]  V. Pinskerova,et al.  Tibiofemoral movement 2: the loaded and unloaded living knee studied by MRI , 2000 .

[5]  J. Tamura,et al.  In Vivo Three-Dimensional Knee Kinematics Using a Biplanar Image-Matching Technique , 2001, Clinical orthopaedics and related research.

[6]  J. J. Jacobs,et al.  Malrotation Causing Patellofemoral Complications After Total Knee Arthroplasty , 1998, Clinical orthopaedics and related research.

[7]  Guoan Li,et al.  The Kinematics of Fixed- and Mobile-Bearing Total Knee Arthroplasty , 2003, Clinical orthopaedics and related research.

[8]  S. Piazza,et al.  Measurement of the screw-home motion of the knee is sensitive to errors in axis alignment. , 2000, Journal of biomechanics.

[9]  E S Grood,et al.  A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. , 1983, Journal of biomechanical engineering.

[10]  Y Hirasawa,et al.  Computed tomography measurement of the surgical and clinical transepicondylar axis of the distal femur in osteoarthritic knees. , 2001, The Journal of arthroplasty.

[11]  V. Pinskerova,et al.  Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee , 2000 .

[12]  G. Li,et al.  Variability of a three-dimensional finite element model constructed using magnetic resonance images of a knee for joint contact stress analysis. , 2001, Journal of biomechanical engineering.

[13]  C. Olcott,et al.  The Ranawat Award. Femoral component rotation during total knee arthroplasty. , 1999, Clinical orthopaedics and related research.

[14]  M. Freeman,et al.  Anteroposterior and rotational movement of femur during knee flexion. , 1999, Clinical orthopaedics and related research.

[15]  R A Berger,et al.  Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis. , 1993, Clinical orthopaedics and related research.

[16]  Ashutosh Kumar Singh,et al.  The Axes of Rotation of the Knee , 1993, Clinical orthopaedics and related research.

[17]  L Blankevoort,et al.  Helical axes of passive knee joint motions. , 1990, Journal of biomechanics.

[18]  Harry E Rubash,et al.  Kinematics of the knee at high flexion angles: An in vitro investigation , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[19]  V Pinskerova,et al.  The movement of the knee studied by magnetic resonance imaging. , 2003, Clinical orthopaedics and related research.

[20]  V M Spitzer,et al.  Three-Dimensional Morphology of the Distal Part of the Femur Viewed in Virtual Reality , 2001, The Journal of bone and joint surgery. American volume.

[21]  Todd Johnson,et al.  Biomechanics of Posterior-Substituting Total Knee Arthroplasty: An In Vitro Study , 2002, Clinical orthopaedics and related research.

[22]  Yoshiki Yamano,et al.  Tibiofemoral movement 3: full flexion in the living knee studied by MRI , 2000 .

[23]  G. Li,et al.  Cruciate-retaining and cruciate-substituting total knee arthroplasty: an in vitro comparison of the kinematics under muscle loads. , 2001, The Journal of arthroplasty.