Aim

To assess the efficacy of combined medical and surgical management in obtaining normal lower limb mechanical alignment in a patient cohort with genotypically similar hypophosphataemic rickets.

Introduction: Understanding the in vivo motions of human joints has become increasingly important. Researchers have used in vitro (cadavers), non-invasive (gait labs), and in vivo (RSA, fluoroscopy) approaches to assess human knee motion. The objective of this study was to use fluoroscopy and computer tomography (CT) to accurately determine the 3D, in vivo, weight-bearing kinematics of normal knees.

Methods: Five normal knees clinically assessed as having no pain or ligamentous laxity were analyzed. Using CT scanning, slices were obtained six inches proximal to the joint line on the femur and six inches of the proximal tibia. Three-dimensional CAD models of each subject’s femur, tibia and patella were recreated from the 3D bone density data. Each subject was then asked to perform five weight-bearing activities while under fluoroscopic surveillance: (1) deep knee bend, (2) normal gait, (3) chair rise, (4) chair sit, and (5) stair descent. The computer-generated 3D models of each subject’s femur and tibiaon (> 1