Kinematics of the Natural and Replaced Knee

Coles, L G; Gheduzzi, S; Miles, A W; Gill, H. S.

doi:10.1007/978-1-4471-6660-3_2

Cited by 3 publications

(5 citation statements)

References 81 publications

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“…The proximal patella appears to have had a similar pattern of movement to the human patella; that is, mainly undergoing flexion of the patellofemoral joint (defined here as rotation around the Z axis of the knee) by an average of 62°, compared to 35–40° across a comparable joint range in humans (shown, e.g., in Fernandez, Akbarshahi, Kim, & Pandy, ; Suzuki, Hosseini, Li, Gill, & Li, ), and by other studies where patellar flexion range is ∼70% of knee flexion (Amis, Senavongse, & Bull, ; Belvedere et al., ). The proximal patella underwent comparatively little tilt and rotation at the patellofemoral joint (defined here as rotation around the proximodistal axis and craniocaudal axis of the knee, respectively); both negligible in our ostrich and similarly small but variable in humans (typically under 10°: Amis et al., ; Belvedere et al., ; Coles, Gheduzzi, Miles, & Gill, ; Iranpour, Merican, Baena, Cobb, & Amis, ). Unlike in humans, the proximal patella did not undergo an appreciable mediolateral shift (here translation along the mediolateral knee axis) in our study.…”

Section: Discussionmentioning

confidence: 82%

“…Unlike in humans, the proximal patella did not undergo an appreciable mediolateral shift (here translation along the mediolateral knee axis) in our study. The proximal patella also appeared to remain constrained within the patellar sulcus (trochlea) of the femur throughout extension, also unlike humans, where it leaves the sulcus proximally near maximal extension (Coles et al., ). This may be because ostriches do not achieve the same high degree of knee extension as humans.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of the moment arms and kinematics of ostrich (Struthio camelus) double patellar sesamoids

et al. 2017

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The patella ("kneecap") is a biomechanically important feature of the tendinous insertion of the knee extensor muscles, able to alter the moment arm lengths between its input and output tendons, and so modify the mechanical advantage of the knee extensor muscle. However, patellar gearing function is little-explored outside of humans, and the patella is often simplified or ignored in biomechanical models. Here, we investigate patellar gearing and kinematics in the ostrich-frequently used as an animal analogue to human bipedal locomotion and unusual in its possession of two patellae at the knee joint. We use x-ray reconstruction of moving morphology (XROMM) techniques to capture the kinematics of the patellae in an adult ostrich cadaver, passively manipulated in flexion-extension. Moment arm ratios between the input and output tendons of each patella are calculated from kinematically determined centers of patellofemoral joint rotation. Both patellae are found to decrease the mechanical advantage of the extensor muscle-tendon complex, decreasing the tendon output force for a given muscle input force, but potentially increasing the relative speed of knee extension. Mechanically and kinematically, the proximal patella behaves similarly to the single patella of most other species, whereas the distal patella has properties of both a fixed retroarticular process and a moving sesamoid. It is still not clear why ostriches possess two patellae, but we suggest that the configuration in ostriches benefits their rapid locomotion and provides tendon protection.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Analysis of the moment arms and kinematics of ostrich (Struthio camelus) double patellar sesamoids

et al. 2017

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“…Rather, the normal knee moves with the medial side staying very nearly stable like a ball-and-socket joint while the lateral side moves front to back, rotating around the centre of the medial side. 57 – 59 Implants designed according to the four-bar link kinematic model had asymmetric multi-radius femoral components (80–90°’). These designs (either cruciate retaining or posterior cruciate sacrificing), although designed to exhibit a normal posterior roll-back in flexion, often slide anteriorly (paradoxical movement – sagittal buckling) due to loss of stabilizing structures and inadequate tibiofemoral congruity.…”

Section: Kinematic Implant Designmentioning

confidence: 99%

“…These designs (either cruciate retaining or posterior cruciate sacrificing), although designed to exhibit a normal posterior roll-back in flexion, often slide anteriorly (paradoxical movement – sagittal buckling) due to loss of stabilizing structures and inadequate tibiofemoral congruity. 57 The combination of contemporary knee kinematics with our modern understanding of the anatomy of the posterior femoral condyles 60 and the axis of knee rotation 61 led to the development of single radius femoral components (1980’) and constant radius (late 1990’) medial pivot designs with medially congruent polyethylene liners. 20 , 56 Medial pivot designs from different manufacturers have shown sagittal stability and satisfactory long-term objective and subjective outcomes.…”

Section: Kinematic Implant Designmentioning

confidence: 99%

Individualized surgery in primary total knee arthroplasty

Karachalios

Komnos

2020

EFORT Open Reviews

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Total knee arthroplasty (TKA) is a satisfactory procedure for end-stage knee joint pathology. However, there is a significant incidence of unsatisfied patients. In recent years conventional total knee arthroplasty surgical technique has been challenged and a modern trend to respect individual anatomy, alignment and soft tissue laxities has been developed. The indications, limits and outcomes of these modern techniques in selected patients are not well-defined. Modern technology (navigation, patient-specific instrumentation and robotics) has improved accuracy of the osteotomies but their effect on long-term outcomes is still unclear. A technique which respects individual anatomy, laxities and alignment in combination with an implant which is designed to incorporate contemporary knee kinematics, without the use of modern technology, is presented. Cite this article: EFORT Open Rev 2020;5:663-671. DOI: 10.1302/2058-5241.5.190085

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“…Во избежание данных осложнений мягкотканный этап операции дополняют применением аппарата внешней фиксации (АВФ), наиболее часто -аппарата Илизарова [18,19,20,21]. Известно, что одноосевой шарнирный механизм не позволяет воспроизвести кинематику движений в коленном суставе [22,23,24]. Однако это возможно при использовании ортопедических гексаподов [25,26,27,28].…”

Section: Introductionunclassified

Treatment of Extension Knee Contractures with Ilizarov Apparatus Versus Orthopedic Hexapod Ortho-SUV Frame

Rokhoev¹,

Чугаев²,

Соломин³

2022

Traumatology and Orthopedics of Russia

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Background. In case if it is impossible to eliminate the knee contracture by soft tissue release, external fixation is additionally used. Most often, the Ilizarov apparatus with a uniaxial hinge is used for this purpose. Orthopedic hexapods, unlike the Ilizarov frame, are able to reproduce the kinematics of movements in the knee joint. Aim of the study to evaluate the effectiveness of orthopedic hexapod for the treatment of patients with knee extension contractures in comparison with the Ilizarov apparatus. Methods. We analyzed 64 cases of combined treatment of extension knee contractures, which were divided into two groups. In the 1st group (31 patients) in addition to the soft tissue release, the orthopedic hexapod Ortho-SUV Frame (OSF) was used. In the 2nd group (33 patients) the Ilizarov apparatus with an uniaxial hinge was used. In a comparative analysis between groups, the number of flexion-extension cycles, the time required to complete them, and the time needed for complete knee range of motion (ROM) restoration were evaluated. Functional results were assessed using specialized scales-questionnaires KSS, Lysholm, LEFS in 2 days, 6 and 12 mon. after frame dismantling. Results. Comparing the total external fixation period, as well as the time needed for ROM restoration, no significant difference between groups was found (р0.05). When using the orthopedic hexapod, in comparison with the Ilizarov apparatus, fewer flexion-extension cycles were required. When assessing the amplitude of movements in 12 mon. in the first group, excellent results were found in 27 patients and good results in 4. In the second group, in all 33 patients good ROM was evaluated. On average, the ROM in the 1st group was 20 more than in the 2nd group. The knee function in 12 mon. was 16 points higher on the KSS in the 1st group, 5 points higher on the Lysholm scale, and 15 points higher on the LEFS scale than in the 2nd group. When analyzing the frequency of complications, no significant differences were found (р0.05). Conclusions. The results obtained indicate the effectiveness of the orthopedic hexapod in the treatment of patients with knee extension contractures.

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Kinematics of the Natural and Replaced Knee

Cited by 3 publications

References 81 publications

Analysis of the moment arms and kinematics of ostrich (Struthio camelus) double patellar sesamoids

Analysis of the moment arms and kinematics of ostrich (Struthio camelus) double patellar sesamoids

Individualized surgery in primary total knee arthroplasty

Treatment of Extension Knee Contractures with Ilizarov Apparatus Versus Orthopedic Hexapod Ortho-SUV Frame

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