Influence of Bone Morphology on In Vivo Tibio-Femoral Kinematics in Healthy Knees during Gait Activities

Abstract

An improved understanding of the relationships between bone morphology and in vivo tibio-femoral kinematics potentially enhances functional outcomes in patients with knee disorders. The aim of this study was to quantify the influence of femoral and tibial bony morphology on tibio-femoral kinematics throughout complete gait cycles in healthy subjects. Twenty-six volunteers underwent clinical examination, radiographic assessment, and dynamic video-fluoroscopy during level walking, downhill walking, and stair descent. Femoral computer-tomography (CT) measurements included medial condylar (MC) and lateral condylar (LC) width, MC and LC flexion circle, and lateral femoral condyle index (LFCI). Tibial CT measurements included both medial (MTP) and lateral tibial plateau (LTP) slopes, depths, lengths, and widths. The influence of bony morphology on tibial internal/external rotation and anteroposterior (AP)-translation of the lateral and medial compartments were analyzed in a multiple regression model. An increase in tibial internal/external rotation could be demonstrated with decreasing MC width β: −0.30 (95% CI: −0.58 to −0.03) (p = 0.03) during the loaded stance phase of level walking. An increased lateral AP-translation occurred with both a smaller LC flexion circle β: −0.16 (95% CI: −0.28 to −0.05) (p = 0.007) and a deeper MTP β: 0.90 (95% CI: 0.23 to 1.56) (p = 0.01) during the loaded stance phase of level walking. The identified relationship between in vivo tibio-femoral kinematics and bone morphology supports a customized approach and individual assessment of these factors in patients with knee disorders and potentially enhances functional outcomes in anterior cruciate ligament injuries and total knee arthroplasty.

Extent of posterolateral tibial plateau impaction fracture correlates with anterolateral complex injury and has an impact on functional outcome after ACL reconstruction

“…Accordingly, the high-grade TPIF group included (insignificantly) more non-contact and less contact ACL injuries compared to the low-grade TPIF group. Moreover, according to the tibia morphology, some knees are probably more susceptible to pivoting than others [ 14 ]. However, it is suggestive that excessive pivoting force, while resulting in higher graded TPIF and ALC injury, should also cause increased assessable instability.…”

Bone morphology features associated with knee kinematics may not be predictive of ACL elongation during high‐demand activities

“…Previous reports have shown that LPTS is a risk factor for high‐grade pivot shift [5, 22, 32], ACL injury [6, 27], and graft failure after ACL reconstruction [8, 41]. Regarding the knee kinematics, Hodel et al [18] reported that a steeper LPTS was not related to tibial anteroposterior translation or tibial rotation during level walking in 26 healthy volunteers imaged using dynamic video‐fluoroscopy. On the other hand, Kikuchi [23] et al reported a steeper LPTS was positively correlated with the maximum tibial internal rotation during a single‐leg drop jump in patients after ACL reconstruction who were imaged using a conventional motion capture system.…”

“…Recent studies have shown increased interest in the association between bony morphology and knee kinematics [4,18,23,35]. Speciically, a steeper LPTS was associated with more tibial internal rotation during drop jumps [23,35].…”

“…Specifically, a steeper LPTS was associated with more tibial internal rotation during drop jumps [23, 35]. Additionally, deeper MTP depth and tibial slope asymmetry were linked to greater lateral tibial anteroposterior translation in healthy individuals during level walking [18].…”

Evaluating the reliability of the lateral femoral condyle measuring methods by different modalities for patients with lateral patellar dislocation

“…The reconstructed midsagittal plane is parallel to the cortex of lateral femoral condyle with approximately 10–15 degrees of internal rotation in the anteroposterior direction. Two circles were drawn to the bony edge and were congruent with the sphericity of the LFC [ 20 ] (Fig. 2 A).…”