A three‐dimensional MRI analysis of knee kinematics

Abstract

Purpose: To quantify normal, in vivo tibio‐femoral knee joint kinematics in multiple weight bearing positions using non‐invasive, high‐resolution MRI and discuss the potential of developing future kinematic methods to assess patients with abnormal joint pathologies. Methods: Ten volunteers with clinically normal knees pushed inferiorly on the footplate of a weight bearing apparatus inside the MR scanner. The volunteers held the weight (133 N) for five scans as the knee motion was evaluated from 0° to 60° of flexion. Full extension was set as the zero point for all measured parameters. Using 3D reconstructions, tibia motion relative to the femur and flexion angle was measured as varus–valgus angle, axial rotation, anterior–posterior translation, and medial–lateral translation. Medial and lateral compartment tibio‐femoral contact areas were examined and centroids of the contract areas were calculated. Results: Tibial internal rotation averaged 4.8° at 40° of flexion and then decreased. Tibial valgus increased by 8° at 60° of flexion. Femoral roll back also increased to 18.5 mm average at 60° of flexion, while the tibia translated medially 2.5 mm. Medial compartment femoro‐tibial contact area started at 374 mm2 and decreased to 308 mm2 with flexion of 60°, while lateral compartment contact area did not change significantly from 276 mm2. Conclusions: Results correlate with previous studies of knee kinematics while providing greater three‐dimensional detail. MR imaging allows excellent non‐invasive evaluation of knee joint kinematics with weight bearing. This tool may potentially be used for assessing knee kinematics in patients with knee pathology. © 2003 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.

Magnetic resonance imaging of in vivo kinematics after total knee arthroplasty

“…Further studies will be necessary to determine if TKA designs, which constrain the position of the tibiofemoral joint and produce more normal knee kinematics, may be associated with improved patellar position after TKA. (18,19) are plotted in solid and dash lines. The standardized data have shown a significant correlation between ITR and MPT (R ϭ 0.90, P ϭ 0.04), which indicates the more internal the tibial rotation, the more medial the patellar translation.…”

“…were standardized to previously published normal values using a similar method: (1) where mean and SD were obtained from the normal kinematics at the specific flexion angle (18,19). Following the data standardization, a linear correlation test was executed between any two of the measurements.…”

“…One of the patients who had a relatively large flexion angle was imaged without using a restraining knee holder and was therefore able to flex the knee to 57°. To investigate the deviation from normal knee kinematics, the measure- ments in TKA patients were compared with the normal kinematic data obtained previously (18,19). Although the method in this study was similar to the one in references 18 and 19, a slightly different registration method was used in determining the measurements.…”

Dynamic MRI Assessment of Normal Knee Kinematics

“…Several studies related to dynamic imaging of human knee have been carried out to characterize movements of bones in the knee using MRI [4,[22][23][24][25][26]. However, the motion is quasi-static, in that the knee is imaged at fixed angles and not in continuous motion.…”

Total knees designed for normal kinematics evaluated in an up‐and‐down crouching machine

“…[1][2][3][4][5][6][7][8][9] Main findings have been posterior displacement of the lateral femoral condyle with flexion and a relatively immobile medial femoral condyle, producing internal tibial rotation of about 208 through a full range of flexion. Likely advantages of posterior displacement include an increased quadriceps lever arm and the facilitation of a high flexion angle by delaying impingement of the posterior tibia with the posterior femoral cortex.…”