Measurement of the screw-home motion of the knee is sensitive to errors in axis alignment

Piazza, Stephen J.; Cavanagh, Peter R.

doi:10.1016/s0021-9290(00)00056-7

Cited by 208 publications

(142 citation statements)

References 18 publications

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“…33 Since the ROM in the nonsagittal planes remained within reasonable limits, even at extreme flexion angles, and was similar to results observed by other researchers, it is not believed that error due to kinematic crosstalk could have had a significant effect on the results.…”

Section: Discussionsupporting

confidence: 87%

Hip, knee, and ankle kinematics of high range of motion activities of daily living

et al. 2006

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Treatment of joint disease that results in limited flexion is often rejected by patients in non-Western cultures whose activities of daily living require a higher range of motion at the hip, knee, or ankle. However, limited information is available about the joint kinematics required for high range of motion activities, such as squatting, kneeling, and sitting cross-legged, making it difficult to design prosthetic implants that will meet the needs of these populations. Therefore, the objective of this work was to generate three-dimensional kinematics at the hip, knee, and ankle joints of Indian subjects while performing activities of daily living. Thirty healthy Indian subjects (average age: 48.2 AE 7.6 years) were asked to perform six trials of the following activities: squatting, kneeling, and sitting cross-legged. Floating axis angles were calculated at the joints using the kinematic data collected by an electromagnetic motion tracking device with receivers located on the subject's foot, shank, thigh, and sacrum. A mean maximum flexion of 1578 AE 68 at the knee joint was required for squatting with heels up. Mean maximum hip flexion angles reached up to 958 AE 278 for squatting with heels flat. The high standard deviation associated with this activity underscored the large range in maximum hip flexion angles required by different subjects. Mean ankle range of flexion reached 588 AE 148 for the sitting cross-legged activity. The ranges of motion required to perform the activities studied are greater than that provided by most currently available joint prostheses, demonstrating the need for high range of motion implant design. ß

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Section: Discussionsupporting

confidence: 87%

Hip, knee, and ankle kinematics of high range of motion activities of daily living

et al. 2006

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“…This motion is thought to be a complex function of surface geometry, tension of ligamentous structures and the action of muscles [6,15]. Several investigations were performed to determine whether screw-home motion occurs in TKA [6,15,19,22,24]. The asymmetry of the tibial articular surface and properly tensioned posterior cruciate ligament were suggested to be important factors in allowing the screw-home motion to occur in TKA [24].…”

Section: Discussionmentioning

confidence: 99%

Synchronisation of tibial rotational alignment with femoral component in total knee arthroplasty

Lee

Seo

Moon

2007

International Orthopaedics (SICO

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The rotational axis of the tibial component in total knee arthroplasty described by Insall is generally accepted, but rotational mismatch between the femoral and the tibial components can occur because the alignment of each component is determined separately. We developed a connecting instrument to synchronise the axis of the tibia to the axis of the femur. We compared the rotational axis of the tibial component using our method and medial one third of tibial tuberosity (Insall's reference) in 70 consecutive TKAs. The rotational axis of the tibial component from the femoro-tibial synchronisation was rotated internally 13.8°± 5.8°(range, 2°-24°) more than the axis of Insall's reference. Eighty three percent of patellae tracked centrally and the patellae tilt measured 2.2°on average. More attention should be given to the rotational congruency between the femorotibial components, because the recent prosthetic design has more conforming articular surfaces.Résumé La rotation axiale du composant tibial dans la prothèse totale du genou décrite par Insall est généralement acceptée mais elle peut poser problème lorsqu'il existe un trouble de rotation sur le composant fémoral et le composant tibial du fait d'une détermination séparée de la position de chaque composant au moment de l'implantation. Nous avons pour cela développé un instrument qui permet de synchroniser l'axe du tibia et l'axe du fémur. Nous avons comparé la rotation axiale du composant tibial en utilisant notre méthode à propos de 70 prothèses totales consécutives du genou. L'axe de rotation après synchronisation des deux composants a été noté en rotation interne. Cette rotation interne est plus importante que celle prévue par l'axe de référence d'Insall qui est représenté par le tiers interne de la tubérosité tibio-intérieure. 83% des rotules avaient une course normale et un accrochage rotulien a été noté dans 2,2% en moyenne. Une attention particulière doit être portée à la congruence en rotation des éléments fémoro-tibiaux pendant l'implantation d'une PTG d'autant que cette congruence est plus importante dans les nouveaux dessins de prothèses totales du genou récentes.

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“…This occurs when a component of one joint rotation is falsely interpreted as contributing to another rotation of interest, and concurrently, a component of the joint rotation of interest is lost. 4 Such misalignments in knee joint CS have been shown to cause erroneous abduction angle and external rotation measurements. 4,5 In order to address the inaccuracies associated with precisely locating anatomical features such as the humeral epicondyles, some investigators have used digitizations of the articular anatomy to calculate the elbow flexion axis.…”

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confidence: 99%

Motion‐derived coordinate systems reduce inter‐subject variability of elbow flexion kinematics

Ferreira

King

Johnson

2010

Journal Orthopaedic Research

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The selection of a joint coordinate system affects the outcome of motion pathways. We developed coordinate systems for the ulna and humerus, which are generated from upper extremity motion. These Motion-Derived Coordinate Systems (CS) were compared to traditional Anatomy-Derived CS created using surface digitizations of anatomical features. Within-subject repeatability of creating MotionDerived CS was quantified. In vitro elbow flexion was generated in the gravity-dependent position using an active upper extremity motion simulator. Kinematic pathways of those motions were calculated in terms of valgus angulation and internal rotation of the ulna relative to the humerus, using both CS. The method of creating Motion-Derived CS was highly repeatable-less than 0.5 mm and 18 for all coordinate directions measured. Inter-subject variability of active flexion pathways was reduced with Motion-Derived CS compared to AnatomyDerived CS ( p < 0.05). The decrease in inter-subject kinematic variability when using Motion-Derived CS may increase the statistical power of biomechanical studies and allow for reduced sample sizes. This minimally invasive method, which also determines the elbow flexion and forearm rotation axes and center of the capitellum, may also be applicable in computer-navigated surgery of the upper limb. ß

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Measurement of the screw-home motion of the knee is sensitive to errors in axis alignment

Cited by 208 publications

References 18 publications

Hip, knee, and ankle kinematics of high range of motion activities of daily living

Hip, knee, and ankle kinematics of high range of motion activities of daily living

Synchronisation of tibial rotational alignment with femoral component in total knee arthroplasty

Motion‐derived coordinate systems reduce inter‐subject variability of elbow flexion kinematics

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