Three‐dimensional patellar motion at the natural knee during passive flexion/extension. An in vitro study

Belvedere, Claudio; Leardini, Alberto; Bianchi, Luca; Catani, Fabio; Giannini, Sandro

doi:10.1002/jor.20919

Cited by 24 publications

(38 citation statements)

References 35 publications

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“…The antero-posterior, proximo-distal and medio-lateral directions are denoted, respectively, by X f , Y f , and Z f at the femur and by X t , Y t , Z t at the tibia. The corresponding origins are at the most distal point of the femoral groove and the deepest point in the sulcus between the medial and lateral tibial intercondylar tubercules (Belvedere et al, 2007a(Belvedere et al, , 2009). Calculation of knee flexion/extension, internal/external rotation, and adduction/abduction was based on these anatomical reference frames and according to a standard articular convention (Grood and Suntay, 1983).…”

Section: Methodsmentioning

confidence: 99%

“…1) with 0.51/0.5 mm nominal accuracy and 10 Hz sampling frequency (Belvedere et al, 2007a(Belvedere et al, , 2009). The pointer-like tracker was used for anatomical landmark calibration, necessary for defining the anatomical-based reference frames, whereas two standard trackers were used for bone tracking, i.e.…”

Section: Methodsmentioning

confidence: 99%

“…the independent degree of freedom over which the other five degrees were described. By this configuration (Belvedere et al, 2007a(Belvedere et al, , 2009, the passive three-dimensional motion of the femur and tibia was measured.…”

Section: Methodsmentioning

confidence: 99%

“…The joint capsule was then opened and a number of bony landmarks were digitized or estimated (Belvedere et al, 2007a(Belvedere et al, , 2009, with their local coordinates used to define the anatomical reference frames (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Does medio-lateral motion occur in the normal knee? An in-vitro study in passive motion

Belvedere¹,

Leardini²,

Giannini³

et al. 2011

Journal of Biomechanics

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Does medio-lateral motion occur in the normal knee? An in-vitro study in passive motion

Belvedere¹,

Leardini²,

Giannini³

et al. 2011

Journal of Biomechanics

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“…3 While most follow-up studies reported that knee flexion after TKA of between 110 to 1208, 4 many studies investigated knee biomechanics in deep flexion to understand the biomechanical factors that may affect flexion capabilities. 1,2,[5][6][7][8][9] Among these factors, the function of the patellar tendon, an essential component of the extensor mechanism, plays a critical role.…”

mentioning

confidence: 99%

In‐vivo patellar tendon kinematics during weight‐bearing deep knee flexion

Kobayashi

Sakamoto

Hosseini

et al. 2012

Journal Orthopaedic Research

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This study quantified in-vivo 3D patellar tendon kinematics during weight-bearing deep knee bend beyond 1508. Each knee was MRI scanned to create 3D bony models of the patella, tibia, femur, and the attachment sites of the patellar tendon on the distal patella and the tibial tubercle. Each attachment site was divided into lateral, central, and medial thirds. The subjects were then imaged using a dual fluoroscopic image system while performing a deep knee bend. The knee positions were determined using the bony models and the fluoroscopic images. The patellar tendon kinematics was analyzed using the relative positions of its patellar and tibial attachment sites. The relative elongations of all three portions of the patellar tendon increased similarly up to 608. Beyond 608, the relative elongation of the medial portion of the patellar tendon decreased as the knee flexed from 608 to 1508 while those of the lateral and central portions showed continuous increases from 1208 to 1508. At 1508, the relative elongation of the medial portion was significantly lower than that of the central portion. In four of seven knees, the patellar tendon impinged on the tibial bony surface at 1208 and 1508 of knee flexion. These data may provide useful insight into the intrinsic patellar tendon biomechanics during a weight-bearing deep knee bend and could provide biomechanical guidelines for future development of total knee arthroplasties that are intended to restore normal knee function. ß 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30: [1596][1597][1598][1599][1600][1601][1602][1603] 2012 Keywords: patellar tendon elongation; patellar tendon orientation; deep knee flexion; weight-bearing activity; knee kinematics Maximum flexion of the knee reaches beyond 1508. 12 Restoration of knee function in the entire flexion range after total knee arthroplasty (TKA) has been challenging. 3 While most follow-up studies reported that knee flexion after TKA of between 110 to 1208, 4 many studies investigated knee biomechanics in deep flexion to understand the biomechanical factors that may affect flexion capabilities. 1,2,5-9 Among these factors, the function of the patellar tendon, an essential component of the extensor mechanism, plays a critical role.Numerous in vitro studies reported the material properties, 10,11 orientation, and/or moment arms of the patellar tendon. 12 In vivo studies measured patellar tendon elongation using ultrasound 13 and MRI. 14 MRI was also used to determine the orientation and moment arms of the patellar tendon. 15,16 Foil strain gages were used to measure the mid-point patellar tendon strain intra-operatively. 17 Recently, DeFrate et al. 18 investigated patellar tendon kinematics using a combined MRI and dual fluoroscopic image technique. However, most of these studies examined patellar tendon biomechanics within the range of knee flexion up to 1108. 18,19 Quantitative data on the patellar tendon function in deep knee flexion are still unclear.Our objective was ...

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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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Three‐dimensional patellar motion at the natural knee during passive flexion/extension. An in vitro study

Cited by 24 publications

References 35 publications

Does medio-lateral motion occur in the normal knee? An in-vitro study in passive motion

Does medio-lateral motion occur in the normal knee? An in-vitro study in passive motion

In‐vivo patellar tendon kinematics during weight‐bearing deep knee flexion

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

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