Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee

Iwaki, Hiroaki; Pinskerová, V.; Freeman, Michael

doi:10.1302/0301-620x.82b8.10717

Cited by 441 publications

(195 citation statements)

References 4 publications

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“…This finding is consistent with prior studies of anterior cruciate ligament retaining total knee arthroplasty [12,13], but the translations were greater than reported in studies of medial unicondylar knee arthroplasty [7] or the healthy knee [21,22] for quasi-static activities. It was particularly surprising in the bi-unicondylar knees that the medial and lateral condyles translated posteriorly the same amount in early flexion (0°-40°), again contrasting with reports of normal knee kinematics during quasi-static activities [21,22].…”

Section: Discussionsupporting

confidence: 91%

Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements

Banks

Fregly

Boniforti

et al. 2005

Knee Surg Sports Traumatol Arthrosc

149

100

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Preserving both cruciate ligaments in unicondylar knee arthroplasty likely provides more normal knee mechanics and contributes to enhanced patient function. It follows that preserving both cruciate ligaments with total knee arthroplasty should provide functional benefit compared to arthroplasty sacrificing one or both cruciates. The purpose of this study was to compare knee kinematics in patients with optimally functioning cruciate-preserving medial unicondylar and bi-unicondylar arthroplasty to determine if knee motions differed. Eight consenting patients with seven medial unicondylar and five bi-unicondylar arthroplasties were studied using lateral fluoroscopy during treadmill gait, stair stepping, and maximum flexion activities. Patient-specific geometric models based on CT and CAD data were used for shape matching to determine the three-dimensional knee kinematics. Tibiofemoral contact locations were computed for the replaced compartments. Maximum flexion in kneeling was 135 degrees +/-14 degrees for unicondylar knees and 123 degrees +/-14 degrees for bi-unicondylar knees (p=0.22). For 0 degrees -30 degrees flexion during the stair activity, the medial condyle translated posterior 3.5+/-2.5 mm in unicondylar knees and 4.7+/-1.9 mm in bi-unicondylar knees (p>0.05). Lateral posterior translation was 5.0+/-2.3 mm in bi-unicondylar knees for 0 degrees -30 degrees flexion. From heel-strike to mid-stance phase, there was little tibial rotation, but unicondylar knees showed 1.5+/-1.6 mm posterior translation of the medial condyle, while bi-unicondylar knees showed 5.1+/-2.2 mm (p<<0.05). The bi-unicondylar knees showed 3.8+/-3.4 mm posterior lateral condylar translation. Preserving both cruciate ligaments in knee arthroplasty appears to maintain some basic features of normal knee kinematics. Knees with bi-unicondylar arthroplasty showed kinematics closer to motions observed in total knee arthroplasty, slightly less weight-bearing flexion, and greater dynamic laxity in gait than unicondylar knees. Despite kinematic differences, knees with unicondylar and bi-unicondylar arthroplasty can provide excellent functional outcomes in appropriately selected patients.

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Section: Discussionsupporting

confidence: 91%

Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements

Banks

Fregly

Boniforti

et al. 2005

Knee Surg Sports Traumatol Arthrosc

149

100

View full text Add to dashboard Cite

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“…Group A consisted of ten female and seven male, 13 left knee, average age of 69.3 years old (45-81). Their average knee score was 169.3 (120-198) representing 11 category A patients, 4 category B and 2 category C. The average follow up was 10.7 months (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Group B consisted of 13 female and 5 male, 7 left knee, …”

Section: Clinical Resultsmentioning

confidence: 99%

Assessment of posterior stability in total knee replacement by stress radiographs

Louisia¹,

Siebold²,

Canty³

et al. 2005

Knee Surg Sports Traumatol Arthrosc

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The aim of this study was to assess the posterior stability of two different designs of total knee replacement (TKR) with deep-dished mobile bearing (MB) implants using stress X-rays. In a prospective non-randomized consecutive study, 34 patients with primary osteoarthritis of the knee underwent TKR. In group A (17 knees), they received a MB insert with a Duracon prosthesis and in group B (18 knees), a Genesis prosthesis. In all cases the posterior cruciate ligament (PCL) was resected. All patients had pre- and post-operative kneeling X-rays and were clinically evaluated with the Knee Society Score. Measurements on the radiographs were taken by tracing a line along the posterior cortex of the tibia and then measuring the perpendicular distance to a point marked at the posterior corner of Blumensaat's line. The average follow up was 10.7 months for group A and 5.4 months for group B. No statistical difference could be found in terms of clinical results and pre- and post-operative kneeling X-rays between the two groups. In each group, all knees demonstrated a significant posterior tibial translation postoperatively compare to their pre-operative status (p<0.0001). There are advantages in resecting the PCL in TKR: mobile flexion gap, correction of fixed deformity, more flexibility to adjust the joint line. The use of a deep dished polyethylene (PE) insert provides stability and use of MB insert reduces PE wear whilst retaining congruity. Two designs of deep-dished MB inserts showed significant posterior tibial translation on stress X-rays. It remains to be determined what amount of laxity is optimal for clinical function and polyethylene longevity.

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“…These findings are Full paper: Mapping gonarthrosis with 3-T 3D-DESS MRI BJR consistent with the study of Iwaki et al on the analysis of tibiofemoral movement of the knee joint. 20 Various classifications are currently applied predominantly for arthroscopic evaluation of cartilage defects. 21 New classification systems focus mainly on objective parameters, such as lesion depth and extent, and less on surface/superficial properties.…”

Section: Discussionmentioning

confidence: 99%

Mapping tibiofemoral gonarthrosis: an MRI analysis of non-traumatic knee cartilage defects

Evangelopoulos

Huesler

Ahmad

et al. 2015

BJR

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Objective: Arthroscopy is "the gold standard" for the diagnosis of knee cartilage lesions. However, it is invasive and expensive, and displays all the potential complications of an open surgical procedure. Ultra-high-field MRI now offers good opportunities for the indirect assessment of the integrity and structural changes of joint cartilage of the knee. The goal of the present study is to determine the site of early cartilaginous lesions in adults with non-traumatic knee pain. Methods: 3-T MRI examinations of 200 asymptomatic knees with standard and three-dimensional doubleecho steady-state (3D-DESS) cartilage-specific sequences were prospectively studied for early degenerative lesions of the tibiofemoral joint. Lesions were classified and mapped using the modified Outerbridge and modified International Cartilage Repair Society classifications.Results: A total of 1437 lesions were detected: 56.1% grade I, 33.5% grade II, 7.2% grade III and 3.3% grade IV. Cartographically, grade I lesions were most common in the anteromedial tibial areas; grade II lesions in the anteromedial L5 femoral areas; and grade III in the centromedial M2 femoral areas. Conclusion: 3-T MRI with standard and 3D-DESS cartilagespecific sequences demonstrated that areas predisposed to early osteoarthritis are the central, lateral and ventromedial tibial plateau, as well as the central and medial femoral condyle. Advances in knowledge: In contrast with previous studies reporting early cartilaginous lesions in the medial tibial compartment and/or in the medial femoral condyle, this study demonstrates that, regardless of grade, lesions preferentially occur at the L5 and M4 tibial and L5 and L2 femoral areas of the knee joint.

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Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee

Cited by 441 publications

References 4 publications

Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements

Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements

Assessment of posterior stability in total knee replacement by stress radiographs

Mapping tibiofemoral gonarthrosis: an MRI analysis of non-traumatic knee cartilage defects

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