Asymmetry in healthy adult knee kinematics revealed through biplane radiography of the full gait cycle

Gale, Tom; Anderst, William

doi:10.1002/jor.24222

Cited by 18 publications

(14 citation statements)

References 26 publications

(74 reference statements)

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“…It is important to view these reported SSD values in the appropriate context. Gale and Anderst 11 recently reported the typical SSD of ATT and TR in healthy individuals during level walking. In that study, the mean SSD of ATT in the stance phase was 1.3 ± 0.9 mm, while that of TR was 4.1°± 2.5°.…”

Section: Discussionmentioning

confidence: 99%

Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

et al. 2021

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Background: Lateral extra-articular tenodesis (LET) in combination with anterior cruciate ligament (ACL) reconstruction (ACLR) has been proposed to improve residual rotatory knee instability in patients having ACL deficiency. Purpose/Hypothesis: The purpose was to compare the effects of isolated ACLR (iACLR) versus LET in combination with ACLR (ACLR+LET) on in vivo kinematics during downhill running. It was hypothesized that ACLR+LET would reduce the internal rotation of the reconstructed knee in comparison with iACLR. Study Design: Controlled laboratory study. Methods: A total of 18 patients with ACL deficiency were included. All participants were randomly assigned to receive ACLR+ LET or iACLR during surgery. Six months and 12 months after surgery, knee joint motion during downhill running was measured using dynamic biplane radiography and a validated registration process that matched patient-specific 3-dimensional bone models to synchronized biplane radiographs. Anterior tibial translation (ATT; positive value means “anterior translation”) and tibial rotation (TR) relative to the femur were calculated for both knees. The side-to-side differences (SSDs) in kinematics were also calculated (operated knee–contralateral healthy knee). The SSD value was compared between ACLR+LET and iACLR groups using a Mann-Whitney U test. Results: At 6 months after surgery, the SSD of ATT in patients who had undergone ACLR+LET (–1.9 ± 2.0 mm) was significantly greater than that in patients who had undergone iACLR (0.9 ± 2.3 mm) at 0% of the gait cycle (foot strike) ( P = .031). There was no difference in ATT 12 months after surgery. Regarding TR, there were no differences between ACLR+LET and iACLR at either 6 months ( P value range, .161-.605) or 12 months ( P value range, .083-.279) after surgery. Conclusion: LET in combination with ACLR significantly reduced ATT at the instant of foot strike during downhill running at 6 months after surgery. However, this effect was not significant at 12 months after surgery. The addition of LET to ACLR had no effect on TR at both 6 and 12 months after surgery. Clinical Relevance: LET in combination with ACLR may stabilize sagittal knee motion during downhill running in the early postoperation phase, but according to this study, it has no effect on 12-month in vivo kinematics. Registration: NCT02913404 ( ClinicalTrials.gov identifier)

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Section: Discussionmentioning

confidence: 99%

Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

et al. 2021

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“…Given this limitation, the design of the 6DOF model can make up for this shortcoming. The 6DOF model independently tracks the movement of the foot and has 3 markers [ 29 , 30 ], so it seems to be better than the HH model.…”

Section: Discussionmentioning

confidence: 99%

Biomechanics Analysis of the Lower Limbs in 20 Male Sprinters Using the International Society of Biomechanics Six-Degrees-of-Freedom Model and the Conventional Gait Model

Zuo

et al. 2021

Med Sci Monit

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Background This biomechanics study of the lower limbs aimed to compare the use of the International Society of Biomechanics Six-Degrees-of-Freedom (ISB-6DOF) model and the conventional gait model (CGM), formerly known as the Helen Hayes model, in 20 male sprinters who habitually used the forefoot (FF) or rearfoot (RF) strike modes. Material/Methods We used a motion capture system to compare the difference in lower-extremity joint mechanics between sprinters’ forefoot or rearfoot strike mode during unplanned sidestepping (UPSS). Twenty elite sprinters participated in a motion capture test under 2 models. Each of the 10 participants were classified as having a habitual forefoot strike mode or rearfoot strike mode during unplanned sidestepping. Joint mechanics and gait parameters were calculated according to the designed movement. Results Comparison of the 2 models showed that the knee joint angles were inconsistent ( P <0.05), highlighting the difficulty of the Helen Hayes model in anatomical recognition. The results of the 2 models show that during the unplanned sidestepping, the sprinter using the habitual rearfoot strike mode had a greater load through the knee joint ( P <0.05). Sprinters who used the habitual forefoot strike mode experienced greater load through their ankle joints ( P <0.05). Conclusions The findings from this biomechanics study showed that when compared with the ISB-6DoF model, the findings from the CGM were more reproducible for the evaluation of FF and RF strike during unplanned sidestepping.

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“…Commercial software was used to identify bone tissue within each scan (Mimics; Materialize) and three‐dimensional (3D) models of each femur and tibia were created separately for the left and right knees. Anatomic coordinate systems were constructed in each right femur and tibia based upon femoral condyle and hip joint center locations, and tibial plateau and ankle joint center locations according to previously established methods 33 and mirror imaged onto the left side after coregistering the corresponding right and left bones for each subject (Figure 1D).…”

Section: Methodsmentioning

confidence: 99%

“…Knee rotations were calculated following the Grood and Suntay convention 35 . Knee translations were calculated using the vector from the femur origin, located at the midpoint of the femoral condyles, to the tibia origin, located at the midpoint of the most medial and lateral borders of the tibial plateau 33 (Figure 1F), and expressed in the tibial coordinate system. Left knee kinematics results were mirrored to match the sign convention for the right knee.…”

Section: Methodsmentioning

confidence: 99%

“…(F) Joint kinematics were calculated according to the anatomical coordinate systems [Color figure can be viewed at wileyonlinelibrary.com] tibia were created separately for the left and right knees. Anatomic coordinate systems were constructed in each right femur and tibia based upon femoral condyle and hip joint center locations, and tibial plateau and ankle joint center locations according to previously established methods33 and mirror imaged onto the left side after coregistering the corresponding right and left bones for each subject (Figure1D). Knee motion was determined for each trial using a previously validated volumetric model-based tracking process that matches a digitally reconstructed radiograph generated from the CT-based bone model to the biplane radiographs with in vivo accuracy of 0.7 mm or better in translation and 0.9°or better in rotation34…”

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confidence: 99%

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Symmetry and sex differences in knee kinematics and ACL elongation in healthy collegiate athletes during high‐impact activities revealed through dynamic biplane radiography

Nishida

Gale

et al. 2021

Journal Orthopaedic Research

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The objectives of this study were to determine symmetry and sex differences in knee kinematics and anterior cruciate ligament (ACL) elongation waveforms in healthy athletes without a history of a knee injury during fast running, drop jump, and 180°internal/external rotation hops. It was hypothesized that knee abduction angle and ACL relative elongation would be greater in women than in men during all activities. Bilateral knee kinematics and ACL relative elongation were determined in 19 collegiate athletes using dynamic biplane radiography. Sex differences in kinematics and ACL relative elongation waveforms were identified using statistical parametric mapping. Average absolute side-to-side differences (SSD A ) in kinematics and ACL relative elongation waveforms were determined for each activity. Women had up to 2.3°(all p < 0.05) less knee adduction angle and had greater ACL relative elongation (max. 4.8%-9.2%; all p < 0.01) than men during all activities, in support of the hypotheses. SSD A in kinematics were 1.4 mm and 5.5°or less in all components of translation and rotation, respectively, while SSD A in ACL relative elongation was 3.6% or less across all activities. Greater ACL relative elongation across a variety of activities may make women more susceptible to ACL injury than men. This study provides valuable reference data for identifying abnormal asymmetry in knee kinematics and ACL elongation in athletes after the ACL injury. These novel results improve our understanding of ACL elongation during demanding athletic activities and may help guide the development of sex-specific risk screening metrics, return to play assessments, and rehabilitation protocols after the ACL injury.

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Asymmetry in healthy adult knee kinematics revealed through biplane radiography of the full gait cycle

Cited by 18 publications

References 26 publications

Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Biomechanics Analysis of the Lower Limbs in 20 Male Sprinters Using the International Society of Biomechanics Six-Degrees-of-Freedom Model and the Conventional Gait Model

Symmetry and sex differences in knee kinematics and ACL elongation in healthy collegiate athletes during high‐impact activities revealed through dynamic biplane radiography

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