In Vivo Three-Dimensional Knee Kinematics Using a Biplanar Image-Matching Technique

A biplanar image-matching technique was developed and applied to a study of normal knee kinematics in vivo under weightbearing conditions. Three-dimensional knee models of six volunteers were constructed using computed tomography. Projection images of the models were fitted onto anteroposterior and lateral radiographs of the knees at hyperextension and every 15° from 0° to 120° flexion. Knee motion was reconstructed on the computer. The femur showed a medial pivoting motion relative to the tibia during knee flexion, and the average range of external rotation associated with flexion was 29.1°. The center of the medial femoral condyle translated 3.8 mm anteriorly, whereas the center of the lateral femoral condyle translated 17.8 mm posteriorly. This rotational motion, with a medially offset center, could be interpreted as a screw home motion of the knee around the tibial knee axis and a posterior femoral rollback in the sagittal plane. However, the motion of the contact point differed from that of the center of the femoral condyle when the knee flexion angle was less than 30°. Within this range, medial and lateral contact points translated posteriorly, and a posterior femoral rollback occurred. This biplanar image-matching technique is useful for investigating knee kinematics in vivo.