Abstract
Due to technology advancement, many studies have reported on in-vivo human knee kinematics recently (Dannis, 2005; Moro-oka, 2008; Tashman, 2003; Koo, 2008). This abstract summarized the joint kinematics during three motions usually seen in our daily living, i.e. gait, step-up (stair ascending) and single-legged lunge that was measured using a combined dual-fluoroscopic imaging system and MRI based modeling technique (Li, 2008). Cartilage contacts or condylar motion using transepicondylar axis (TEA)/geometric center axis (GCA) were used to describe the motion characters of the knee during these motions.
In the treadmill gait, the movement of the medial femoral condyle along the anteroposterior direction was significantly greater than that of the lateral femoral condyle during the stance phase using either TEA (9.7 ± 0.7 mm vs. 4.0 ± 1.7 mm, respectively; p < 0.01; Fig. 1A) or GCA (17.4 ± 2.0 mm vs. 7.4 ± 6.1 mm, respectively; p < 0.01; Fig. 1B). A “lateral-pivoting” of the knee was observed (Kozanek, 2009).
In the step-up motion, both medial and lateral contact points moved anteriorly on the tibial articular surfaces along the step-up motion path. The contact points on the medial and lateral tibial plateau moved anteriorly (13.5 ± 3.2 mm vs. 10.7 ± 5.0 mm, respectively; p > 0.05; Fig. 2A) with knee extension. Using the TEA (Fig. 2B), the femoral condylar motions presented a similar pattern as the contact points; nonetheless, using the GCA (Fig. 2C), the femoral condylar motion pattern was dramatically different. The medial condyle moved anteriorly, while the lateral condyle shifted posteriorly. However, none of them showed a significant pivoting phenomenon (Li, 2013).
In the single-legged lunge, both medial and lateral contact points moved similarly before 120° of knee flexion, but the lateral contact moved posteriorly and significantly more than the medial compartment in high flexion (1.9 ± 2.1 mm vs. 4.8 ± 2 mm, respectively; p < 0.05). The single-legged lunge didn't show a single motion pattern (Fig. 3) (Qi, 2013).
These data provide baseline knowledge for the understanding of normal physiological function of the knee during gait, step-up and lunge activities. The findings of these studies demonstrated that knee joint kinematics is activity-dependent and indicated that the knee joint motions could not be described using a single motion character such as “medial-pivoting” that has recently been popularized in total knee arthroplasty design areas.
