Net moments of TKA during level walking based on video-fluoroscopy coupled with force plate data

Zihlmann, Monika Silvia; List, Renate; Gerber, Hans; Stüssi, Edgar

doi:10.1016/s0021-9290(06)83416-0

Cited by 3 publications

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“…However, due to the limited field of view of the stationary image intensifier, static systems can only be applied for the analysis of highly restricted movements [ 11 , 12 ]. To overcome these limitations, mobile devices such as the robotic radiographic imaging platform [ 13 , 14 ], the mobile fluoroscopy system [ 15 ], the mobile biplane X-ray imaging system [ 9 ], and the moving fluoroscope [ 3 , 6 , 7 , 16 ], have all been developed to allow the tracking of the knee during complete gait cycles of level gait, stair and ramp walking.…”

Section: Introductionmentioning

confidence: 99%

Influence of the moving fluoroscope on gait patterns

et al. 2018

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Video-fluoroscopic analysis can provide important insights for the evaluation of outcome and functionality after total knee arthroplasty, allowing the in vivo assessment of tibiofemoral kinematics without soft tissue artefacts. To enable measurement of the knee throughout activities of daily living such as gait, robotic systems like the moving fluoroscope have been developed that follow the knee movement and maintain the joint in front of the image intensifier. Since it is unclear whether walking while being accompanied by moving fluoroscope affects normal gait, the objective of this study was to investigate its influence on gait characteristics in healthy subjects. In addition, the impact of the motors’ noise was analysed.By means of skin markers analysis (VICON MX system, Oxford Metrics Group, UK) and simultaneous measurement of ground reaction forces (Kistler force plates, Kistler, Switzerland), gait characteristics when walking with and without the moving fluoroscope as well as with and without ear protectors in combination with the moving fluoroscope, were obtained in young (n = 10, 24.5y ± 3.0y) and elderly (n = 9, 61.6y ± 5.3y) subjects during level gait and stair descent. Walking with the moving fluoroscope significantly decreased gait velocity in level gait and stair descent over the respective movement without the fluoroscope. Statistical analysis, including gait velocity as a covariate, resulted in no differences on the ground reaction force parameters. However, some kinematic parameters (ankle, knee and hip ranges of motion, minimal knee angle in late stance phase, maximal knee angles in stance and swing phase) seemed to be modified by the presence of the moving fluoroscope, but statistical comparison was limited due to velocity differences between the conditions. Wearing ear protectors to avoid the influence of motor sound during walking with the moving fluoroscope caused no significant difference.Walking with the moving fluoroscope has been shown to decrease gait velocity and small alterations in kinematic parameters were observed. Therefore, gait and movement alterations due to the moving fluoroscope cannot completely be excluded. However, based on the absence of differences in ground reaction force parameters (when adjusted for velocity within ANCOVA), as well as based on the comparable shape of the angular curves to the slow control condition, it can be concluded that changes in gait when walking with the moving fluoroscope are small, especially in comparison to natural slow walking. In order to allow assessment of joint replacement with the moving fluoroscope, including an understanding of the effects of joint pain, clinical analyses can only be compared to gait activities showing similarly reduced velocities. Importantly, the reduced gait speeds observed in this study are similar to those observed after total knee arthroplasty, suggesting that analyses in such subjects are appropriate. However, the moving fluoroscope would likely need to be optimized in order to detect natural gait characterist...

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Section: Introductionmentioning

confidence: 99%

Influence of the moving fluoroscope on gait patterns

et al. 2018

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“…Prior work has reported knee kinematics observed by a moving fluoroscope with [15] and without ground reaction forces [44,29] during gait. However, none of the aforementioned work has contrasted their subjects' gait with and without the dynamic imaging system, and therefore have not addressed the influence of that system on their subjects' motions.…”

Section: Introductionmentioning

confidence: 99%

Does close proximity robot motion tracking alter gait?

Yamokoski

Banks

2011

Gait & Posture

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A comprehensive assessment of the musculoskeletal system: The CAMS-Knee data set

Taylor

Schütz

Bergmann

et al. 2017

Journal of Biomechanics

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Combined knowledge of the functional kinematics and kinetics of the human body is critical for understanding a wide range of biomechanical processes including musculoskeletal adaptation, injury mechanics, and orthopaedic treatment outcome, but also for validation of musculoskeletal models. Until now, however, no datasets that include internal loading conditions (kinetics), synchronized with advanced kinematic analyses in multiple subjects have been available. Our goal was to provide such datasets and thereby foster a new understanding of how in vivo knee joint movement and contact forces are interlinked - and thereby impact biomechanical interpretation of any new knee replacement design. In this collaborative study, we have created unique kinematic and kinetic datasets of the lower limb musculoskeletal system for worldwide dissemination by assessing a unique cohort of 6 subjects with instrumented knee implants (Charité - Universitätsmedizin Berlin) synchronized with a moving fluoroscope (ETH Zürich) and other measurement techniques (including whole body kinematics, ground reaction forces, video data, and electromyography data) for multiple complete cycles of 5 activities of daily living. Maximal tibio-femoral joint contact forces during walking (mean peak 2.74 BW), sit-to-stand (2.73 BW), stand-to-sit (2.57 BW), squats (2.64 BW), stair descent (3.38 BW), and ramp descent (3.39 BW) were observed. Internal rotation of the tibia ranged from 3° external to 9.3° internal. The greatest range of anterio-posterior translation was measured during stair descent (medial 9.3 ± 1.0 mm, lateral 7.5 ± 1.6 mm), and the lowest during stand-to-sit (medial 4.5 ± 1.1 mm, lateral 3.7 ± 1.4 mm). The complete and comprehensive datasets will soon be made available online for public use in biomechanical and orthopaedic research and development.

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Net moments of TKA during level walking based on video-fluoroscopy coupled with force plate data

Cited by 3 publications

References 0 publications

Influence of the moving fluoroscope on gait patterns

Influence of the moving fluoroscope on gait patterns

Does close proximity robot motion tracking alter gait?

A comprehensive assessment of the musculoskeletal system: The CAMS-Knee data set

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