Posterior Displacement of the Tibia Increases in Deep Flexion of the Knee

Fukagawa, Shingo; Matsuda, Shuichi; Tashiro, Yasutaka; Hashizume, Makoto; Iwamoto, Yukihide

doi:10.1007/s11999-009-1118-x

Cited by 13 publications

(11 citation statements)

References 23 publications

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“…However, during gait and running cycle, the knee was shown to rotate with respect to an axis that is located on the lateral side of the knee (Dyrby and Andriacchi, 2004; Hoshino and Tashman, 2012; Koo and Andriacchi, 2008; Kozanek et al, 2009), where Dyrby and Koo measured the kinematics of the knee during walking or leg extension using the motion analysis, Hoshino investigated the kinematics of the knee during running using CT 3D model and dynamic stereo X-ray system and Kozanek studied the kinematics of the knee during walking using the MRI 3D model and the dual fluoroscopy imaging system. These studies on various weight-bearing functions of the knee reported various patterns of the medial and lateral femoral condyle translations, which do not support the medial-pivoting description of the knee flexion (Fukagawa et al, 2010; Johal et al, 2005; Tanifuji et al, 2011). Instead, these data indicated that the kinematics is not uniform along the knee flexion path, especially during higher flexion, indicating that the knee kinematics is activity (or loading) dependent.…”

Section: Discussionmentioning

confidence: 83%

“…Many studies reported that during knee flexion, the translation of the femoral condyle with respect to tibial plateau is slightly towards posterior on medial side, whereas the lateral femoral condyle translated consistently in the posterior direction (Fukagawa et al, 2010; Johal et al, 2005; Tanifuji et al, 2011). This type of knee motion behavior has been referred to as a medial-pivoting rotation of the knee (Hill et al, 2000; Jensen, 2005; Johal et al, 2005; Tanifuji et al, 2011), where the knee axially rotates with respect to an axis located on the medial side of the knee during flexion (Johal et al, 2005; Tanifuji et al, 2011), Hill and Johal investigated the kinematics of the knee using open-MRI and Tanifuji used single-plane fluoroscopy during squatting.…”

Section: Discussionmentioning

confidence: 99%

“…For example, Most et al defined the femoral condyles along the transepicondylar line (Most et al, 2004); Tanifuji et al described the femoral condyles using the geometric center line (Tanifuji et al, 2011); many directly measured the tibiofemoral translations using the motion of the articular contact points (DeFrate et al, 2004b; Fukagawa et al, 2010; Hill et al, 2000; Nakagawa et al, 2000), where Defrate et al (DeFrate et al, 2004b) measured tibiofemoral contact kinematics using the direct cartilage contact using MRI 3D model and dual fluoroscopy during weight-bearing single-legged lunge and Dennis et al (Dennis et al, 2005) using the closest locations between the tibial and femoral boney surfaces with the CT 3D model and single plane fluoroscopy during weight-bearing deep knee bend. In current study, both the transepicondylar line and the tibiofemoral cartilage contact were used to describe the femoral condyles motions from full extension to maximal flexion of the knee.…”

Section: Discussionmentioning

confidence: 99%

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In vivo kinematics of the knee during weight bearing high flexion

Hosseini

Tsai

et al. 2013

Journal of Biomechanics

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Achieving high flexion is an objective of contemporary total knee arthoplasty, however little is known on the knee biomechanics at high flexion under weight-bearing conditions. This study is to investigate the 6DOF kinematics and tibiofemoral cartilage contact biomechanics of the knee during weight-bearing flexion from full extension to maximal flexion. Eight knees from seven healthy subjects with no history of injuries or chronic pain were recruited. The knees were MRI scanned to create 3D models of the tibia and femur, including their articular cartilage surfaces. The subjects were then imaged using a dual fluoroscopic image system while performing a weight-bearing quasi-static single-legged lunge from full extension to maximal flexion. The 6DOF kinematics and the articular cartilage contact locations were measured along the flexion path of the knee. The result indicated that the internal tibial rotation increased sharply at low flexion angles (full extension to 30°), maintained a small variation in the middle range of flexion (30° to 120°), and then sharply increased again at high flexion angles (120° to maximal flexion). The contact point moved similarly in the medial and lateral compartments before 120° of flexion, but less on the medial compartment at high flexion angles. The results indicated that the knee motion couldn’t be described using one character in the entire range of flexion, especially in high flexion. The knee kinematic data in the entire range of flexion of the knee could be instrumental for designing new knee prostheses to achieve physical high flexion and improving rehabilitation protocols after knee injuries.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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In vivo kinematics of the knee during weight bearing high flexion

Hosseini

Tsai

et al. 2013

Journal of Biomechanics

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“…In the healthy knee, the lateral tibiofemoral joint gap is significantly lax [17]. Posterior displacement with posterior stress was larger in the lateral compartment at 90° and 135° flexion [18]. Although achieving normal stability and kinematics in replaced knees is challenging, these kinematic data should be beneficial for designing high-flexion total knee prostheses.…”

Section: Resultsmentioning

confidence: 99%

In VivoHealthy Knee Kinematics during Dynamic Full Flexion

Hamai

Morooka

Dunbar

et al. 2013

BioMed Research International

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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.

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“…Pivoting patterns of the intact healthy knee has been studied under different loading conditions. Medial‐pivoting pattern has been reported in non‐weight‐bearing seated positions, weight‐bearing squatting positions and during deep knee flexion in normal healthy subjects . This phenomenon has been attributed to the convex lateral and concave medial condyles of the normal tibial plateau.…”

Section: Discussionmentioning

confidence: 96%

Bi‐Cruciate Retaining Total Knee Arthroplasty Does Not Restore Native Tibiofemoral Articular Contact Kinematics During Gait

Tsai

Liow

et al. 2019

Journal Orthopaedic Research

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Bi-cruciate retaining (BCR) total knee arthroplasty (TKA) design preserves both anterior and posterior cruciate ligaments with the potential to restore normal posterior femoral rollback and joint kinematics. Abnormal knee kinematics and "paradoxical" anterior femoral translation in conventional TKA designs have been suggested as potential causes of patient dissatisfaction. However, there is a paucity of data on the in vivo kinematics and articular contact behavior of BCR-TKA. This study aimed to investigate in vivo kinematics, articular contact position, and pivot point location of the BCR-TKA during gait. In vivo kinematics of 30 patients with unilateral BCR-TKA during treadmill walking was determined using validated dual fluoroscopic imaging tracking technique. The BCR-TKA exhibited less extension than the normal healthy knee between heel strike and 48% of gait cycle. Although the average external rotation trend observed for BCR TKA was similar to the normal healthy knee, the range of motion was not fully comparable. The lowest point of the medial condyle showed longer anteroposterior translation excursion than the lateral condyle, leading to a lateral-pivoting pattern in 60% of BCR TKA patients during stance phase. BCR-TKA demonstrated no statistical significant differences in anterior-posterior translation as well as varus rotation, when compared to normal healthy knees during the stance phase. However, sagittal plane motion and tibiofemoral articular contact characteristics including pivoting patterns were not fully restored in BCR TKA patients during gait, suggesting that BCR TKA does not restore native tibiofemoral articular contact kinematics.

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Posterior Displacement of the Tibia Increases in Deep Flexion of the Knee

Cited by 13 publications

References 23 publications

In vivo kinematics of the knee during weight bearing high flexion

In vivo kinematics of the knee during weight bearing high flexion

In VivoHealthy Knee Kinematics during Dynamic Full Flexion

Bi‐Cruciate Retaining Total Knee Arthroplasty Does Not Restore Native Tibiofemoral Articular Contact Kinematics During Gait

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