Three-Dimensional Kinematic Coupling of the Healthy Knee During Treadmill Walking

Abstract

Accurate joint kinematics plays an important role in estimating joint kinetics in musculoskeletal simulations. Biplanar fluoroscopic (BPF) systems have been introduced to measure skeletal kinematics with six degrees-of-freedom. The purpose of this study was to model knee kinematic coupling using knee kinematics during walking, as measured by the BPF system. Seven healthy individuals (mean age, 23 ± 2 yr) performed treadmill walking trials at 1.2 m/s. Knee kinematics was regressed separately for the swing and stance phases using a generalized mixed effects model. Tibial anterior translation function was y=0.20x−3.09 for the swing phase and y=0.31x−0.54 for the stance phase, where x was the flexion angle and y was the tibial anterior translation. Tibial lateral and inferior translation were also regressed separately for the stance phase and the swing phase. Tibial external rotation was y=−0.002x2+0.19x−0.64 for the swing phase and y=−0.19x−1.22 for the stance phase. The tibial adduction rotation function was also calculated separately for the stance and swing phase. The study presented three-dimensional coupled motion in the knee during the stance and swing phases of walking, and demonstrated the lateral pivoting motion found in previous studies. This expanded understanding of secondary knee motion functions will benefit musculoskeletal simulation and help improve the accuracy of calculated kinetics.

Accuracy of the tibiofemoral contact forces estimated by a subject-specific musculoskeletal model with fluoroscopy-based contact point trajectories

“…For validation purpose, the present study and the studies mentioned in perspective are performed on patients with total knee prostheses, but subject-specific contact point trajectories can be obtained the same way on patients or subjects without an implant (Gray et al, 2019;Koo and Koo, 2019). Typically, in the case of knee osteoarthritis, the contact point trajectories, among other joint and muscle factors, are modified by the pathology (Scarvell et al, 2018) and restored by the arthroplasty (Li et al, 2015).…”

“…This implies a slightly altered knee joint position with respect to the force plates and thus altered external flexion-extension and adduction-abduction moments. Second, the muscle lever arms are directly changed (Gerus et al, 2013;Koo and Koo, 2019) as well as musculo-tendon lengths and velocities. Third, the contact points where the contact forces are computed are also directly changed (Dumas et al, 2020b;Zeighami et al, 2018).…”

ISB clinical biomechanics award winner 2021: Tibio-femoral kinematics of natural versus replaced knees – A comparison using dynamic videofluoroscopy

“…Using such techniques, general agreement has been achieved for tibio-femoral kinematics during repetitive flexion tasks (DeFrate et al, 2004;Hamai et al, 2013;Hill et al, 2000;Moro-oka et al, 2008;Pinskerova et al, 2004;Tanifuji et al, 2011). However, results remain controversially discussed regarding tibial internal/external rotation, condylar antero-posterior (A-P) translation, and the resultant centre of rotation (CoR) of the natural knee during dynamic activities such as walking (Dennis et al, 2001;Gray et al, 2019;Komistek et al, 2003;Koo and Koo, 2019;Kozanek et al, 2009;Liu et al, 2010;Postolka et al, 2020b). This controversy plausibly originates from different activity executions and analysis approaches, which are known to result in varying interpretations, albeit of the same joint movement patterns (Postolka et al, 2022).…”