NDLI: In-vivo analysis of flexion axes of the knee: Femoral condylar motion during dynamic knee flexion.

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In-vivo analysis of flexion axes of the knee: Femoral condylar motion during dynamic knee flexion.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Feng, Yong Tsai, Tsung-Yuan Li, Jing-Sheng Rubash, Harry E. Li, Guoan Freiberg, Andrew
Description	Author Affiliation: Feng Y ( Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China); Tsai TY ( Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Tsai.Tsung-Yuan@mgh.harvard.edu.); Li JS ( Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Li.Jing-Sheng@mgh.harvard.edu.); Rubash HE ( Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Hrubash@partners.org.); Li G ( Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Li.Guoan@mgh.harvard.edu.); Freiberg A ( Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Afreiberg@mgh.harvard.edu.)
Abstract	BACKGROUND: Transepicondylar axis and geometrical center axis are widely used for investigation of the knee kinematics and component alignment in total knee arthroplasty. However, the kinematic characteristics of these knee axes are not well defined in literature. This study investigated the femoral condylar motion during a dynamic flexion of the knee using different flexion axes. METHODS: Twenty healthy knees (10 males and 10 females) were CT scanned to create 3D anatomic models. The subjects performed a single leg flexion from full extension to maximum flexion while the knees were imaged using fluoroscopes. The femoral condyle translations in anterior-posterior and proximal-distal directions were described using clinical transepicondylar axis, surgical transepicondylar axis and geometrical center axis. FINDINGS: The subjects achieved -9.4° (SD 3.0°) hyperextension at full extension and 116.4° (SD 9.0°) at maximum flexion of the knee. The anterior-posterior translations of the three flexion axes were different for the medial condyle, but similar for the lateral condyle. Substantial variations of the condylar motion in proximal-distal direction were measured along the flexion path using these axes. While the surgical transepicondylar axis maintained condyle heights from full extension to 60° of flexion, geometrical center axis showed little changes in condyle heights from 30° to maximum knee flexion. The condyles moved distally beyond 90° flexion using both transepicondylar axes. INTERPRETATION: The femoral condylar motion measurement is sensitive to the selection of flexion axis. The different kinematic features of these axes provide an insightful reference when selecting a flexion axis in total knee arthroplasty component alignment.
File Format	HTM / HTML
ISSN	02680033
Volume Number	32
e-ISSN	18791271
Journal	Clinical Biomechanics
Language	English
Publisher	Elsevier
Publisher Date	2016-02-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Biomedical Engineering Discipline Physiology Arthroplasty, Replacement, Knee Methods Femur Surgery Knee Joint Range Of Motion, Articular Adult Biomechanical Phenomena Body Mass Index Female Physiopathology Fluoroscopy Humans Imaging, Three-dimensional Male Models, Anatomic Motion Young Adult Journal Article Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Biophysics Sports Science

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