Geometry and motion of the knee for implant and orthotic design

Kurosawa, H.; Walker, Peter S.; Abe, Shinichi; Garg, Ashima; Hunter, Timothy N.

doi:10.1016/0021-9290(85)90663-3

Cited by 267 publications

(102 citation statements)

References 15 publications

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“…5, specimens 17 and 29). The AP length of the ACL attachment was 18 ± 2 mm (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). This correlated to the size of the tibial plateau: r = 0.46, P = 0.0005 for ML width; r = 0.34, P = 0.0118 for AP depth.…”

Section: Resultsmentioning

confidence: 88%

The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament

Edwards

Bull

Amis

2007

Knee Surg Sports Traumatol Arthr

165

111

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The tibial attachments of the individual anteromedial (AM) and posterolateral (PL) fibre bundles and the entire attachment of the anterior cruciate ligament are described, relating them to consistent bony landmarks; 55 fresh-frozen specimens were measured. The fibre bundles were separated and excised at their attachments and their peripheries marked with a pen. Highresolution scaled digital photographs were taken of each dissected specimen and transferred onto a computer for analysis. A wide variation was found when using the posterior tibial axis, the anterior tibial surface and the medial tibial spine as reference points. The most consistent measurements used the tibial interspinous "over-the-back" ridge as a datum. The attachments of the PL and AM bundles were centred 10 ± 1 mm (mean ± SD) and 17 ± 2 mm anterior to the over-the-back ridge. They were 4 ± 1 and 5 ± 1 mm, respectively, lateral to the medial tibial spine border. The positions of 6 mm circles in the posterior-medial limits of the fibre bundles (representing tunnels in a double-tunnel reconstruction) were measured. The overall dimensions of the tibial plateaux correlated significantly with many measurements. The results from this study could be used to guide ACL reconstruction techniques.

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Section: Resultsmentioning

confidence: 88%

The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament

Edwards

Bull

Amis

2007

Knee Surg Sports Traumatol Arthr

165

111

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“…It is difficult to obtain this information as the groove is curved and slightly different definitions of this axis have been used. One of the reasons for this is that imaging data of the groove geometry from x-rays is not consistent with the geometry of the articular cartilage [31] The medial-lateral axis of the femur has been described in several ways: parallel to a line joining the medial and lateral epicondyles [21] or parallel to a line joining the posterior points of the femoral condyles [11,17], or passing through the centres of the spherical posterior parts of the femoral condyles [16]. It has been shown that the choice of this axis will significantly affect the values obtained for certain components of patellar tracking [3].…”

Section: Figurementioning

confidence: 99%

Standardisation of the description of patellofemoral motion and comparison between different techniques

Bull

Katchburian

Shih

et al. 2002

Knee, Surg, Sports Traumatol, Arthrosc

114

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Patellofemoral motion is significant clinically, yet in the literature many different methods and terminologies are used, thus making comparison between papers difficult. The aim of this study was to review and explain the different methods used for the description of patellofemoral joint motion, compare these methods by experimentation, and propose a standardised method. We found three main methods for describing patellar motion: motion of the patella about femoral body fixed axes, about patellar body fixed axes, or a combination of these. Description about femoral body fixed axes does not make sense clinically. Description about patellar body fixed axes is straightforward, yet the definition of these axes is prone to error due to the lack of anatomical landmarks. The combination method makes most sense clinically and uses more easily found anatomical landmarks. Patellar flexion varied by up to 26% when describing the motion about different axes. Tilt and shift were highly sensitive to the choices of coordinate systems and the axes of motion. The pattern of rotation was consistent between all methods, however, differences between the methods increased with patellar flexion. We propose the description of patello-femoral motion in terms of shift (along a femoral medial-lateral axis), tilt (about the patellar long axis), rotation (about a floating patellar anterior-posterior axis) and flexion (about the femoral medial-lateral axis).

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“…Kurosawa et al [18] observed the spherical nature of the posterior condyles and identified the location of the centers of these spheres, which coincided with the center of the condyles on lateral radiographs. Elias et al [11] divided the femoral condyles into three distinct regions, each with its own radius and center.…”

Section: Introductionmentioning

confidence: 96%

Is Femoral Component Rotation in a TKA Reliably Guided by the Functional Flexion Axis?

Oussedik

Scholes

Ferguson

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background The position of the femoral component in a TKA in the axial plane influences patellar tracking and flexion gap symmetry. Errors in femoral component rotation have been implicated in the need for early revision surgery. Methods of guiding femoral component rotation at the time of implantation typically are derived from the mean position of the flexion-extension axis across experimental subjects. The functional flexion axis (FFA) of the knee is kinematically derived and therefore a patient-specific reference axis that can be determined intraoperatively by a computer navigation system as an alternative method of guiding femoral component rotation. However, it is unclear whether the FFA is reliable and how it compares with traditional methods. Question/purposes We asked if the FFA could be measured reproducibly at different stages of the operative procedure; (2) where it lies in relation to a CT-derived gold standard; and (3) how it compares with more traditional methods of judging femoral component rotation. Methods Thirty-seven patients undergoing elective TKAs were recruited to the study. Preoperative CT scans were obtained and the transepicondylar axis (TEA) was identified. The TKA then was performed using computer navigation. The FFA was derived before incision and again after the surgical approach and osseous registration. The navigation system was used to register the surgical TEA. The FFA and surgical TEA then were compared with the CT-derived TEA. Results The mean preincision FFA was similar to the intraoperative FFA and therefore deemed reproducible. We observed no differences in variability between surgical TEA and preincision FFA. The FFA was different from the CT-TEA and judged similar in accuracy to the surgical TEA. Conclusion The reliability and accuracy of the FFA were similar to those of other intraoperative methods. Further evaluation is required to ascertain whether the FFA improves on currently available methods for determining the ideal rotation of the femoral component during TKA.

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Geometry and motion of the knee for implant and orthotic design

Cited by 267 publications

References 15 publications

The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament

The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament

Standardisation of the description of patellofemoral motion and comparison between different techniques

Is Femoral Component Rotation in a TKA Reliably Guided by the Functional Flexion Axis?

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