Tibiofemoral movement 2: the loaded and unloaded living knee studied by MRI

Hill, P. F.; Vedi, V.; Williams, Andrew M.; Iwaki, Hiroaki; Pinskerová, V.; Freeman, Michael

doi:10.1302/0301-620x.82b8.10716

Cited by 272 publications

(113 citation statements)

References 7 publications

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“…This is supported with findings from fluoroscopy, studies using in vitro analyses, and those using external markers associated with gait laboratory systems [1, 2, 4, 8-10, 12, 13, 16, 18, 19, 21, 22, 24, 25, 34-37]. With increasing knee flexion, the normal knee reportedly experiences more posterior motion of the lateral condyle leading to internal rotation of the tibia with respect to the femur [18,22,25]. In contrast to the normal knee, in vivo kinematic analyses suggest subjects undergoing TKA often experience a motion pattern opposite the normal knee where the condyles slide in the anterior direction with increasing knee flexion [2,8,9,24,28,31,[34][35][36][37].…”

Section: Introductionsupporting

confidence: 70%

In Vivo Kinematics after a Cruciate-substituting TKA

Victor

Mueller

Komistek

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Patterns of motion in the native knee show substantial variability. Guided motion prosthetic designs offer stability but may limit natural variability. To assess these limits, we therefore determined the in vivo kinematic patterns for patients having a cruciate-substituting TKA of one design and determined the intersurgeon variability associated with a guided-motion prosthetic design. Threedimensional femorotibial contact positions were evaluated for 86 TKAs in 80 subjects from three different surgeons using fluoroscopy during a weightbearing deep knee bend. The average posterior femoral rollback of the medial and lateral condyles for all TKAs from full extension to maximum flexion was À14.0 mm and À23.0 mm, respectively. The average axial tibiofemoral rotation from full extension to maximum flexion for all TKAs was 10.8°. The average weightbearing range of motion (ROM) was 1098 (range, 608-1508; standard deviation, 18.78). Overall, the TKA showed axial rotation patterns similar to those of the normal knee, although less in magnitude. Surgeon-to-surgeon comparison revealed dissimilarities, showing the surgical technique and soft tissue handling influence kinematics in a guided-motion prosthetic design.

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Section: Introductionsupporting

confidence: 70%

In Vivo Kinematics after a Cruciate-substituting TKA

Victor

Mueller

Komistek

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Relative tibiofemoral motions medially and laterally were found to be markedly different, as previously described [9,10,13,14]. The medial femoral condyles were found to have less relative movement on the tibias and anteroposterior roll back from extension to 120°of flexion compared with the lateral compartments.…”

Section: Discussionsupporting

confidence: 55%

Kinematic study following double-bundle, anterior cruciate ligament reconstruction

Seon

Song

Bae

et al. 2006

International Orthopaedics (SICO

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The purpose of this study was to evaluate tibiofemoral kinematics after double-bundle anterior cruciate ligament (ACL) reconstructions and compare them with those of successful single-bundle reconstructions and contralateral normal knees using open MR images. We obtained MR images based on the flexion angle without weight-bearing, from 20 patients with successful unilateral single-bundle (10 patients) and double-bundle (10 patients) ACL reconstructions with tibialis anterior allografts and a minimum 1-year follow-up. The MR images of the contralateral uninjured knees were used as normal controls. Sagittal images of the mid-medial and mid-lateral sections of the tibiofemoral compartments were used to measure the translation of the femoral condyles relative to the tibia. The mean translations of the medial femoral condyles on the tibial plateaus during knee joint motion showed no significant differences among normal, single-bundle, and double-bundle ACL reconstructed knees (all p>0.05). The mean translations of the lateral femoral condyles showed a significant difference between normal and single-bundle reconstructed knees, or between single-bundle and doublebundle reconstructed knees (p<0.05). However, there was no significant difference between normal and doublebundle reconstructed knees (p=0.220). These findings suggest that double-bundle ACL reconstruction restores normal kinematic tibiofemoral motion better than singlebundle reconstruction.Résumé Le but de cette étude était d'évaluer, par les images de résonnance magnétique, la cinématique tibiofémorale après reconstruction du ligament croisé antérieur par double tunnel et de la comparer avec celle obtenue après réussite des reconstructions à un seul tunnel et celle du genou normal controlatéral. Nous avons étudié des images basées sur l'angle de flexion en décharge chez 20 patients après reconstruction par allogreffe tibiale antérieure suivis au moins un an : 10 avec succés de la reconstruction par un seul tunnel et 10 avec reconstruction par un double tunnel. Les images du genou controlatéral non traumatisé servaient de contrôle. Des images sagittales de la partie moyenne des compartiments fémoro-tibiaux permettaient la mesure de la translation des condyles fémoraux par rapport au tibia. La translation du condyle interne pendant la flexion du genou n'était pas différente entre le genou normal et la reconstruction par simple ou double tunnel (p>0,05). La translation du condyle externe était significativement différente entre le genou normal et la reconstruction par simple tunnel et entre les reconstructions par simple et double tunnel (p<0,05). Cependant il n'y avait pas de différence entre le genou normal et la reconstruction par double tunnel (p=0,220). Ces résultats suggèrent que la reconstruction du croisé antérieur par double tunnel restore mieux la cinématique du genou que la reconstruction par simple tunnel.

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“…Another study [23] found lateral-but not medial-pivot motion, which we observed in our control group. Hill et al [8] and others [14] observed anterior translation of the medial condyle of 4 mm in 90°, which was slightly more than the findings by Johal et al [10].…”

Section: Discussionmentioning

confidence: 71%

Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

Fitz¹,

Sodha

Reichmann

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Normal knee kinematics is characterized by posterior femorotibial rollback with tibial internal rotation and medial-pivot rotation in flexion. Cruciate-retaining TKAs (CR-TKAs) do not reproduce normal knee kinematics. Questions/purposes We hypothesized a more anatomic reconstruction of the medial femoral condyle, simultaneously preserving the tension of the PCL and medial collateral ligament, resulted in (1) medial-pivot rotation and tibial internal rotation, (2) lateral femoral rollback, and (3) reduced liftoff. Patients and Methods We compared 10 patients who underwent CR-TKA using the new technique at their 1-year followup to a matched control group of nine patients using a traditional gap-balancing technique at their 2-to 4-year followup. All patients received lateral radiographs in extension and flexion, which we utilized for threedimensional implant matching to calculate tibial internal rotation, lateral rollback, and lateral liftoff in extension and flexion. Results The new gap-balancing technique resulted in a median of 3.5°tibial internal rotation with 2.7-mm rollback of the lateral femoral condyle relative to the medial condyle in flexion, which was different from the control group. We found no differences in liftoff between the groups. Conclusions The new technique resulted in tibial internal rotation with flexion and lateral rollback comparing the lateral to the medial condyle in flexion, but no differences in condylar liftoff. These preliminary results were comparable to published kinematic results of an asymmetric CR-TKA or medial-pivot CR-TKA but not to symmetric CR-TKA.

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Tibiofemoral movement 2: the loaded and unloaded living knee studied by MRI

Cited by 272 publications

References 7 publications

In Vivo Kinematics after a Cruciate-substituting TKA

In Vivo Kinematics after a Cruciate-substituting TKA

Kinematic study following double-bundle, anterior cruciate ligament reconstruction

Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

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