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, 42 (12), 1877-84

Tibiofemoral Kinematics and Condylar Motion During the Stance Phase of Gait

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Tibiofemoral Kinematics and Condylar Motion During the Stance Phase of Gait

Michal Kozanek et al. J Biomech.

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 0.67 m/s. 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+/-2.0mm vs. 7.4+/-6.1mm, 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).

Conflict of interest statement

Conflict of Interest Statement

No potential conflict of interest declared.

Figures

Figure 1
Figure 1
A) Subjects were first MR-scanned to construct a 3D knee model. B) Following this, each subject performed gait on a treadmill at 1.5 MPH while the knee was scanned by the DFIS.
Figure 2
Figure 2
Virtual reproduction of the fluoroscopic setup and tibiofemoral kinematics. The 3D MR-based models of the femur and tibia were matched to their projections on the fluoroscopic images.
Figure 3
Figure 3
Two axes were constructed to measure the motion of the femoral condyles during the stance phase of gait. The transepicondylar axis (TEA) connecting the epicondyles and the geometrical center axis (GCA) constructed by fitting circles to the posterior femoral condyles. The white dots represent the centers of femoral condyles on the TEA and GCA. The black dots represent the centers of TEA and GCA.
Figure 4
Figure 4
showing the 6DOF tibiofemoral kinematics of the knee joint measured during the stance phase of treadmill gait. The kinematics reported here represent the motion of femur relative to tibia. Solid lines represent contralateral toe-off, ipsilateral heel-rise and contralateral heel-strike, respectively. The dashed lines denote the kinematic range: maximal and minimal displacement. The intervals between the solid lines represent loading response, midstance, terminal extension and pre-swing, respectively.
Figure 5
Figure 5
Motion of the medial and lateral femoral condyle in the anteroposterior direction measured by tracking the center of each condyle on the transepicondylar axis (TEA) of the femur and projected onto the transverse plane. The medial femoral condyle made greater excursions than lateral femoral condyle.
Figure 6
Figure 6
Excursions of the medial and lateral condyles of the femur during stance phase determined in the anteroposterior direction. Geometrical center axis (GCA) of the femur was constructed for this measurement and the condylar centers were followed throughout the stance phase. Again, the medial femoral condyle was more mobile than the lateral.

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