Effect of flexion angle on the pressure-volume of the human knee

Funk, Daniel A.; Noyes, Frank R.; Grood, Edward S.; Hoffman, Steven D.

doi:10.1016/0749-8063(91)90084-b

Cited by 19 publications

(16 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Minimum IAP has been reported to occur at 30" (17) and 40" (1 1) of flexion, corresponding to the maximal intraarticular capacity measured at 30" of flexion (13). Thus, the "position of ease" of the joint (minimal IAP) falls between 30" and 40" of flexion, corresponding to the position usually assumed by the patient with an acute knee effusion (1 1).…”

Section: Discussionmentioning

confidence: 97%

“…This process may depend on variations of intraarticular pressure (IAP), which is a complex function of volume, time, joint angle, joint history, pathology, fluid distribution, and muscle action (22). Previous investigators have examined the static pressure-volume-joint angle relationships in normal and arthritic human knees (3,10,13,15,22,23,29). O'Driscoll and coworkers studied IAP of rabbit knees after infusion of small and pathologically large volumes of saline and demonstrated sinusoidal pressure variation with CPM in the presence of a large joint effusion (25).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Intraarticular pressure during continuous passive motion of the human knee

Pedowitz

Gershuni

Crenshaw

et al. 1989

Journal Orthopaedic Research

View full text Add to dashboard Cite

Intraarticular pressure (IAP) was continuously monitored during continuous passive motion (CPM) of five normal and 11 abnormal human knees using a new fiberoptic, transducer-tipped Camino catheter. IAP varied in a consistent hysteresis pattern in the normal knees, with subatmospheric pressures recorded at intermediate angles of joint flexion. A similar pattern was recorded in the abnormal knees without cruciate ligament pathology, whereas considerable variability was noted in the knees with cruciate ligament abnormality. IAP was lower in the extension to flexion than in the flexion to extension portion of the CPM cycle, providing evidence of intraarticular fluid flow during portions of the CPM cycle. IAP changes were consistent with "physiologic compartmentation" within the knee at extremes of joint position. Capsular viscoelastic changes and/or synovial fluid volume changes were observed during CPM. The therapeutic mechanism of continuous passive motion may be related to cyclic variation of the intraarticular pressure.

show abstract

Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

Intraarticular pressure during continuous passive motion of the human knee

Pedowitz

Gershuni

Crenshaw

et al. 1989

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…This translates into reduced motion arcs and subsequent reduction in the pumping effect in and around the knee. Because the maximum capacity of the knee capsule occurs at 35°flexion [5,6,8,10], others have hypothesized that attempts should be made to flex the joint beyond this position to create hydrostatic pressures, facilitating the prevention and/or elimination of edema in the joint and periarticular tissues [17]. Given our results, a CPM motion arc greater than 50°would have to be reached before the knee would begin to experience the pumping effects of flexion greater than 35°.…”

Section: Discussionmentioning

confidence: 94%

Actual Knee Motion during Continuous Passive Motion Protocols is Less Than Expected

Bible¹,

Simpson²,

Biswas³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Investigations of the usefulness of continuous passive motion (CPM) after TKA have yielded mixed results, with evidence suggesting its efficacy is contingent on the presence of larger motion arcs. Surprisingly, the range of motion (ROM) the knee actually experiences while in a CPM machine has not been elucidated. In this study, the ability of a CPM apparatus to bring about a desired knee ROM was assessed with an electrogoniometer. The knee experienced only 68% to 76% of the programmed CPM arc, with the higher percentages generated by elevating the head of the patient's bed. This disparity between true knee motion and CPM should be accounted for when designing CPM protocols for patients or investigations evaluating efficacy of CPM.

show abstract

“…The pattern of IAP variations in the knee joint during motion shows minimum IAP at intermediate angles around 45" and maximum pressures at flexion and extension (Eyring and Murray 1964, Jayson and Dixon 1970a, Myers and Palmer 1970, Pedowitz et al 1989, Funk et al 1991. These pressures rise significantly in loaded joint motion (Machan 1983) and during changes in the position of a distended joint Dixon 1970b, Jensen andGraf 1993).…”

Section: Discussionmentioning

confidence: 99%