Tibiofemoral kinematics and condylar motion during the stance phase of gait

Abstract

Accurate knowledge of the dynamic knee motion in vivo is instrumental for understanding normal and pathological function of the knee joint. However, interpreting motion of the knee joint during gait in other than the sagittal plane remains controversial. In this study, we utilized the dual fluoroscopic imaging technique to investigate the six-degree of freedom kinematics and condylar motion of the knee during the stance phase of treadmill gait in eight healthy volunteers at a speed of 0.67m/sec. We hypothesized that the 6DOF knee kinematics measured during gait will be different from those reported for non-weightbearing activities, especially with regards to the phenomenon of femoral rollback. In addition, we hypothesized that motion of the medial femoral condyle in the transverse plane is greater than that of the lateral femoral condyle during the stance phase of treadmill gait. The rotational motion and the anterior-posterior translation of the femur with respect to the tibia showed a clear relationship with the flexion-extension path of the knee during the stance phase. Additionally, we observed that the phenomenon of femoral rollback was reversed, with the femur noted to move posteriorly with extension and anteriorly with flexion. Furthermore, we noted that motion of the medial femoral condyle in the transverse plane was greater than that of the lateral femoral condyle during the stance phase of gait (17.4±2.0 mm vs. 7.4±6.1 mm, respectively; p<0.01). The trend was opposite to what has been observed during non-weightbearing flexion or single-leg lunge in previous studies. These data provide baseline knowledge for the understanding of normal physiology and for the analysis of pathological function of the knee joint during walking. These findings further demonstrate that knee kinematics is activity-dependent and motion patterns of one activity (non-weightbearing flexion or lunge) cannot be generalized to interpret a different one (gait).

Physical Stimulation of Chondrogenic Cells In Vitro: A Review

“…The rotation of the femur with respect to the tibia varies during gait with twin peaks of external rotation being observed during early midstance and toe-off [50]. The same study demonstrated twin peak of valgus at similar points of the stance phase [50]. It is interesting to note this corresponds with the twin peaks of load measured in dogs during gait [29].…”

“…Both compartments demonstrated a cartilage contact deformation of between 10% and 15% and the bulk of this deformation was generated during the first 20 seconds of load [37]. The rotation of the femur with respect to the tibia varies during gait with twin peaks of external rotation being observed during early midstance and toe-off [50]. The same study demonstrated twin peak of valgus at similar points of the stance phase [50].…”

“…Taking these data into account it is clear the loads and pattern of motion in the tibiofemoral joint are complex during gait, and it is unlikely uniaxial loading devices can invoke the complete range of cellular responses. The data obtained under weightbearing gait are different from that under nonweightbearing flexion [50]. This, combined with the lack of clear data, makes it difficult to determine to what extent multiaxial load bioreactors mimic the in vivo environment.…”

A patient-specific wear prediction framework for an artificial knee joint with coupled musculoskeletal multibody-dynamics and finite element analysis

“…In vivo contact forces and joint motions are essential for patient-specific wear prediction [6]. Although in vivo knee contact forces and joint motions have been measured using instrumented knee prostheses [22,23] and fluoroscopic imaging system [24] respectively, it is still difficult to obtain all these information from the same patient simultaneously. Consequently, multibody dynamics (MBD) modelling of TKR by considering the patient-specific lower extremity musculoskeletal (MSK) system is an alternative attractive method to the in vivo measurements [25][26][27].…”

May 2012 Letters to the Editor-in-Chief

“…In fact, it is not clear what happens in a pathological joint-if the bone glides too little or too much and in which direction-and maybe in functional activities, such as walking and running, even in healthy subjects the pattern could be different. 4,8 So, as manual therapists, it could be important to focus on these 2 aspects in future research, to understand which direction of translation is more effective in some specific disorders.…”