scholarly journals In VivoHealthy Knee Kinematics during Dynamic Full Flexion

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Satoshi Hamai ◽  
Taka-aki Moro-oka ◽  
Nicholas J. Dunbar ◽  
Hiromasa Miura ◽  
Yukihide Iwamoto ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Knee Kinematics ◽  
The Other ◽  
Medial Compartment ◽  
Knee Flexion Angle ◽  
Knee Prostheses ◽  
Healthy Knee ◽  
Total Knee ◽  
Full Flexion ◽  
2D Model

Healthy knee kinematics during dynamic full flexion were evaluated using 3D-to-2D model registration techniques. Continuous knee motions were recorded during full flexion in a lunge from 85° to 150°. Medial and lateral tibiofemoral contacts and femoral internal-external and varus-valgus rotations were analyzed as a function of knee flexion angle. The medial tibiofemoral contact translated anteroposteriorly, but remained on the center of the medial compartment. On the other hand, the lateral tibiofemoral contact translated posteriorly to the edge of the tibial surface at 150° flexion. The femur exhibited external and valgus rotation relative to the tibia over the entire activity and reached 30° external and 5° valgus rotations at 150° flexion. Kinematics’ data during dynamic full flexion may provide important insight as to the designing of high-flexion total knee prostheses.

Knee Kinematics During an In Vitro Simulated Deep Flexion Squat

2007 ◽  
Author(s):  
Chadd W. Clary ◽  
Amit M. Mane ◽  
Amber N. Reeve ◽  
Kevin A. Dodd ◽  
Lorin P. Maletsky
Keyword(s):  
Knee Flexion ◽  
Weight Bearing ◽  
Knee Kinematics ◽  
Knee Prostheses ◽  
Deep Flexion ◽  
Total Knee ◽  
Design Characteristics ◽  
Insight Into

Understanding the behavior of the natural knee in deep flexion can offer insight into the necessary design characteristics of a total knee implant. Andriacchi et al. [1] measured the in vivo characteristics of knee motion down to ∼150° knee flexion during a weight bearing squat. Likewise, Li et al. [2] investigated deep knee flexion in vitro using robotic technology during passive knee flexion. Both of these studies offer insight into the behavior of the knee in deep knee flexion; however, they have some limitations with regards to assessing physiological activities in a controlled manner. The purpose of this study was to measure the kinematics of the knee during a simulated in vitro deep knee squat so that in the future a dynamic, load-bearing, simulated deep knee squat could be used as a tool in the design of total knee prostheses.

In Vitro Kinematic Analysis of Single Axis Radius Posterior-Substituting Total Knee Arthroplasty

2020 ◽  
Author(s):  
Paul Arauz ◽  
Yun Peng ◽  
Tiffany Castillo ◽  
Christian Klemt ◽  
Young-Min Kwon
Keyword(s):  
Knee Flexion ◽  
Knee Kinematics ◽  
Lateral Collateral Ligament ◽  
Collateral Ligament ◽  
Flexion Extension ◽  
Healthy Knee ◽  
Joint Biomechanics ◽  
Total Knee ◽  
Intact Knee

AbstractThis is an experimental study. As current posterior-substituting (PS) total knee arthroplasties have been reported to incompletely restore intrinsic joint biomechanics of the healthy knee, the recently designed single axis radius PS knee system was introduced to increase posterior femoral translation and promote ligament isometry. As there is a paucity of data available regarding its ability to replicate healthy knee biomechanics, this study aimed to assess joint and articular contact kinematics as well as ligament isometry of the contemporary single axis radius PS knee system. Implant kinematics were measured from 11 cadaveric knees using an in vitro robotic testing system. In addition, medial collateral ligament (MCL) and lateral collateral ligament (LCL) forces were quantified under simulated functional loads during knee flexion for the contemporary PS knee system. Posterior femoral translation between the intact knee and the single axis radius PS knee system differed significantly (p < 0.05) at 60, 90, and 120 degrees of flexion. The LCL force at 60 degrees (9.06 ± 2.81 N) was significantly lower (p < 0.05) than those at 30, 90, and 120 degrees of flexion, while MCL forces did not differ significantly throughout the range of tested flexion angles. The results from this study suggest that although the contemporary single axis radius PS knee system has the potential to mimic the intact knee kinematics under muscle loading during flexion extension due to its design features, single axis radius PS knee system did not fully replicate posterior femoral translation and ligament isometry of the healthy knee during knee flexion.

scholarly journals Early Spatiotemporal Patterns and Knee Kinematics during Level Walking in Individuals following Total Knee Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Xubo Wu ◽  
Lixi Chu ◽  
Lianbo Xiao ◽  
Yong He ◽  
Shuyun Jiang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Gait Analysis ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Knee Kinematics ◽  
Gait Pattern ◽  
Swing Phase ◽  
Knee Flexion Angle ◽  
Total Knee ◽  
Support Time

Purpose. With the aim of investigating the spatiotemporal features of early gait pattern and knee kinematics after total knee arthroplasty and analyzing the association between outcomes of gait analyses and knee kinematic parameters, the relationship between walking and dynamic knee deformity at the early period after total knee arthroplasty was assessed in this study. Methods. Eighteen patients including 14 women and 4 men who underwent total knee arthroplasty were analyzed using three-dimensional gait analysis system to observe gait parameters and values of maximum knee flexion angle (MKFA) during swing phase and knee flexion angle (KFA) and knee valgus angle (KVA) at midstance phase. Results. 3D gait analysis showed that operated side exhibited significantly less total support time and single support time as well as significantly longer swing phase compared with the other side. During walking, the operated side had significantly smaller MKFA and greater KFA and KVA than the nonoperated side. There was moderate to significant correlation between gait pattern and the dynamic knee kinematics. Conclusion. The gait abnormality of patients after TKA was associated with inadequate flexion of knees at swing phase and insufficient extension at stance phase as well as increased range of valgus.

Gait and Knee Flexion In Vivo Kinematics of Asymmetric Tibial Polyethylene Geometry Cruciate Retaining Total Knee Arthroplasty

2020 ◽  
Author(s):  
Christian Klemt ◽  
John Drago ◽  
Ruben Oganesyan ◽  
Evan J. Smith ◽  
Ingwon Yeo ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Knee Biomechanics ◽  
Functional Activities ◽  
In Vivo Kinematics ◽  
Sit To Stand ◽  
Healthy Knee ◽  
Total Knee

AbstractThe preservation of the posterior cruciate ligament in cruciate retaining (CR) total knee arthroplasty (TKA) designs has the potential to restore healthy knee biomechanics; however, concerns related to kinematic asymmetries during functional activities still exist in unilateral TKA patients. As there is a limited data available regarding the ability of the contemporary CR TKA design with concave medial and convex lateral tibial polyethylene bearing components to restore healthy knee biomechanics, this study aimed to investigate in vivo three-dimensional knee kinematics in CR TKA patients during strenuous knee flexion activities and gait. Using a combined computer tomography and dual fluoroscopic imaging system approach, in vivo kinematics of 15 unilateral CR TKA patients (comparison of replaced and contralateral nonreplaced knee) were evaluated during sit-to-stand, step-ups, single-leg deep lunge, and level walking. The patient cohort was followed-up at an average of 24.5 months ( ± 12.6, range 13–42) from surgical procedure. Significantly smaller internal knee rotation angles were observed for the contemporary CR TKA design during step-ups (2.6 ± 5.8 vs. 6.3 ± 6.6 degrees, p < 0.05) and gait (0.6 ± 4.6 vs. 6.3 ± 6.8 degrees, p < 0.05). Significantly larger proximal and anterior femoral translations were measured during sit-to-stand (34.7 ± 4.5 vs. 29.9 ± 3.1 mm, p < 0.05; –2.5 ± 2.9 vs. –8.1 ± 4.4 mm, p < 0.05) and step-ups (34.1 ± 4.5 vs. 30.8 ± 2.9 mm, p < 0.05; 2.2 ± 3.2 vs. –3.5 ± 4.5 mm, p < 0.05). Significantly smaller ranges of varus/valgus and internal/external rotation range of motion were observed for CR TKA, when compared with the nonoperated nee, during strenuous activities and gait. The preservation of the posterior cruciate ligament in the contemporary asymmetric bearing geometry CR TKA design with concave medial and convex lateral tibial polyethylene bearing components has the potential to restore healthy knee biomechanics; however, the study findings demonstrate that native knee kinematics were not fully restored in patients with unilateral asymmetric tibial polyethylene bearing geometry CR TKA during functional activities.

scholarly journals Kinematic Comparison between Medially Congruent and Posterior-Stabilized Third-Generation TKA Designs

2021 ◽  
Vol 6 (1) ◽  
pp. 27
Author(s):  
Stefano Ghirardelli ◽  
Jessica L. Asay ◽  
Erika A. Leonardi ◽  
Tommaso Amoroso ◽  
Thomas P. Andriacchi ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Knee Kinematics ◽  
Primary Total Knee Arthroplasty ◽  
Flexion Angle ◽  
Heel Strike ◽  
Third Generation ◽  
Knee Flexion Angle ◽  
Posterior Stabilized ◽  
Rotational Angle ◽  
Peak Knee

Background: This study compares knee kinematics in two groups of patients who have undergone primary total knee arthroplasty (TKA) using two different modern designs: medially congruent (MC) and posterior-stabilized (PS). The aim of the study is to demonstrate only minimal differences between the groups. Methods: Ten TKA patients (4 PS, 6 MC) with successful clinical outcomes were evaluated through 3D knee kinematics analysis performed using a multicamera optoelectronic system and a force platform. Extracted kinematic data included knee flexion angle at heel-strike (KFH), peak midstance knee flexion angle (MSKFA), maximum and minimum knee adduction angle (KAA), and knee rotational angle at heel-strike. Data were compared with a group of healthy controls. Results: There were no differences in preferred walking speed between MC and PS groups, but we found consistent differences in knee function. At heel-strike, the knee tended to be more flexed in the PS group compared to the MC group; the MSKFA tended to be higher in the PS group compared to the MC group. There was a significant fluctuation in KAA during the swing phase in the PS group compared to the MC group, PS patients showed a higher peak knee flexion moment compared to MC patients, and the PS group had significantly less peak internal rotation moments than the MC group. Conclusions: Modern, third-generation TKA designs failed to reproduce normal knee kinematics. MC knees tended to reproduce a more natural kinematic pattern at heel-strike and during axial rotation, while PS knees showed better kinematics during mid-flexion.

Biomechanical Comparison of Kinematic and Mechanical Knee Alignment Techniques in a Computer Simulation Medial Pivot Total Knee Arthroplasty Model

2021 ◽  
Author(s):  
Young Dong Song ◽  
Shinichiro Nakamura ◽  
Shinichi Kuriyama ◽  
Kohei Nishitani ◽  
Hiromu Ito ◽  
...  
Keyword(s):  
Femoral Component ◽  
Knee Flexion ◽  
External Rotation ◽  
Knee Kinematics ◽  
Lateral Compartment ◽  
Contact Stresses ◽  
Contact Forces ◽  
Medial Compartment ◽  
Tibial Insert ◽  
Medial Pivot

AbstractSeveral concepts may be used to restore normal knee kinematics after total knee arthroplasty. One is a kinematically aligned (KA) technique, which restores the native joint line and limb alignment, and the other is the use of a medial pivot knee (MPK) design, with a ball and socket joint in the medial compartment. This study aimed to compare motions, contact forces, and contact stress between mechanically aligned (MA) and KA (medial tilt 3° [KA3] and 5° [KA5]) models in MPK. An MPK design was virtually implanted with MA, KA3, and KA5 in a validated musculoskeletal computer model of a healthy knee, and the simulation of motion and contact forces was implemented. Anteroposterior (AP) positions, mediolateral positions, external rotation angles of the femoral component relative to the tibial insert, and tibiofemoral contact forces were evaluated at different knee flexion angles. Contact stresses on the tibial insert were calculated using finite element analysis. The AP position at the medial compartment was consistent for all models. From 0° to 120°, the femoral component in KA models showed larger posterior movement at the lateral compartment (0.3, 6.8, and 17.7 mm in MA, KA3, and KA5 models, respectively) and larger external rotation (4.2°, 12.0°, and 16.8° in the MA, KA3, and KA5 models, respectively) relative to the tibial component. Concerning the mediolateral position of the femoral component, the KA5 model was positioned more medially. The contact forces at the lateral compartment of all models were larger than those at the medial compartment at >60° of knee flexion. The peak contact stresses on the tibiofemoral joint at 90° and 120° of knee flexion were higher in the KA models. However, the peak contact stresses of the KA models at every flexion angle were <20 MPa. The KA technique in MPK can successfully achieve near-normal knee kinematics; however, there may be a concern for higher contact stresses on the tibial insert.

Tibiofemoral Contact After Conventional and High-Flexion Posterior Cruciate-Retaining Total Knee Arthroplasty

2003 ◽  
Author(s):  
Ephrat Most ◽  
Guoan Li ◽  
Harry E. Rubash
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Contact Point ◽  
Knee Kinematics ◽  
Testing System ◽  
High Flexion ◽  
Human Knee ◽  
Contact Points ◽  
Total Knee

The human knee is capable of flexing up to 160°, yet most patients do not achieve more than 120° after total knee arthroplasty (TKA). The translation of the tibiofemoral contact points with flexion is important in the overall understanding of knee kinematics and knee stability, particularly in high flexion. In this study, cadaveric knees were used in conjunction with a robotic testing system and TekScan® film to quantify the tibiofemoral contact between 0°–150° for two TKA designs. We found that, for both TKAs, with increasing knee flexion, the peak contact point moved posteriorly and that the contact area decreased with increasing knee flexion.

Knee Flexion Angle at Initial Contact During Jump Landing in Individuals With and Without Chronic Ankle Instability: A Critically-Appraised Topic

2019 ◽  
Vol 24 (4) ◽  
pp. 151-155
Author(s):  
Jacob T. Hartzell ◽  
Kyle B. Kosik ◽  
Matthew C. Hoch ◽  
Phillip A. Gribble
Keyword(s):  
Knee Flexion ◽  
Sagittal Plane ◽  
Ankle Instability ◽  
Knee Kinematics ◽  
Chronic Ankle Instability ◽  
Flexion Angle ◽  
Initial Contact ◽  
Knee Flexion Angle ◽  
Bottom Line ◽  
Jump Landing

Clinical Scenario: Chronic ankle instability (CAI) is characterized by the residual symptoms and feelings of instability that persist after an acute ankle sprain. Current literature has identified several neuromuscular impairments associated with CAI that may negatively impact sagittal plane knee kinematics during dynamic activities. This has led researchers to begin examining sagittal plane knee kinematics during jump landing tasks. Understanding changes in movement patterns at the knee may assist clinicians in designing rehabilitation plans that target both the ankle and more proximal joints, such as the knee. Clinical Question: What is the evidence to support the notion that patients with CAI have decreased sagittal plane knee flexion angle at initial contact during a jump-landing task compared to healthy individuals? Summary of Key Findings: The literature was systematically searched for level 4 evidence or higher. The search yielded two case-control studies which met the inclusion criteria. Based on limited evidence, there are mixed results for whether sagittal plane knee kinematic at initial contact differ between those with and without CAI. Clinical Bottom Line: There is weak evidence to support changes in sagittal plane knee kinematics at initial contact during a jump landing in individuals with CAI compared to healthy controls. Strength of Recommendation: In accordance with the Centre for Evidence-Based Medicine, a grade of C for level 4 evidence is recommended due to variable findings.

Influence of hip position on knee flexion angle in patients undergoing total knee arthroplasty

2005 ◽  
Vol 20 (5) ◽  
pp. 669-673 ◽  
Author(s):  
Tomoyuki Matsumoto ◽  
Nobuhiro Tsumura ◽  
Seiji Kubo ◽  
Ryoichi Shiba ◽  
Masahiro Kurosaka ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Flexion Angle ◽  
Knee Flexion Angle ◽  
Total Knee
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