Tanifuji Osamu, Sato Takashi, Kobayashi Koichi, Mochizuki Tomoharu, Koga Yoshio, Yamagiwa Hiroshi, Omori Go, Endo Naoto
Department of Orthopaedic Surgery, Niigata Medical Center, 3-27-11 Kobari, Nishi-ku, Niigata, Niigata, 950-2022, Japan.
J Orthop Sci. 2011 Nov;16(6):710-8. doi: 10.1007/s00776-011-0149-9. Epub 2011 Sep 4.
Analysis of the movement of anatomically defined reference axes at the femoral condyles relative to the tibia is appropriate for evaluating knee kinematics. However, such parameters have been previously employed only in studies utilizing stop-motion techniques. The purpose of this study was to evaluate in vivo dynamic kinematics for full range of motion in normal knees using the three-dimensional to two-dimensional registration technique and to compare them with previously reported normal knee kinematics obtained via stop-motion techniques.
Dynamic motion of the right knee was analyzed in 20 healthy volunteers (10 female, 10 male; mean age 37.2 years). Knee motion was observed when subjects squatted from standing with the knee fully extended to maximum flexion. We determined the following parameters: (1) changes to angles of the geometric center axis (GCA) on the tibial axial plane (rotation angle); (2) anteroposterior translations of the medial and lateral ends of the GCA; and (3) motion patterns in each phase during knee flexion.
All subjects exhibited femoral external rotation (26.1°) relative to the tibia throughout knee flexion. The medial femoral condyle demonstrated anterior translation (5.5 mm) from full extension to 100° flexion, and demonstrated posterior translation (3.9 mm) after 100°, while the lateral femoral condyle demonstrated consistent posterior translation (15.6 mm) throughout knee flexion. All subjects showed medial pivot motion from full extension to nearly 120° flexion. From 120° flexion, bicondylar rollback motion was observed.
Although the behavior of the medial femoral condyle in our analysis differed somewhat from that seen in previous cadaver studies, the results obtained using dynamic analysis were generally equivalent to those obtained in previous studies employing stop-motion techniques. These results provide control data for future dynamic kinematic analyses of pathological knees.
分析股骨髁上解剖学定义的参考轴相对于胫骨的运动，适用于评估膝关节运动学。然而，此类参数此前仅用于采用定格动画技术的研究中。本研究的目的是使用三维到二维配准技术评估正常膝关节全范围运动的体内动态运动学，并将其与此前通过定格动画技术获得的正常膝关节运动学进行比较。
对20名健康志愿者（10名女性，10名男性；平均年龄37.2岁）的右膝动态运动进行分析。当受试者从膝关节完全伸展站立状态下蹲至最大屈曲时，观察膝关节运动。我们确定了以下参数：（1）胫骨轴平面上几何中心轴（GCA）角度的变化（旋转角度）；（2）GCA内侧和外侧端的前后平移；（3）膝关节屈曲各阶段的运动模式。
在整个膝关节屈曲过程中，所有受试者的股骨相对于胫骨均表现出向外旋转（26.1°）。股骨内侧髁在从完全伸展到100°屈曲过程中表现出向前平移（5.5毫米），在100°之后表现出向后平移（3.9毫米），而股骨外侧髁在整个膝关节屈曲过程中表现出持续的向后平移（15.6毫米）。所有受试者在从完全伸展到近120°屈曲过程中均表现出内侧枢轴运动。从120°屈曲开始，观察到双髁后滚运动。
尽管我们分析中股骨内侧髁的行为与先前尸体研究中所见略有不同，但使用动态分析获得的结果总体上与先前采用定格动画技术的研究结果相当。这些结果为未来病理性膝关节的动态运动学分析提供了对照数据。
