Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan.
Department of Orthopaedic Surgery, Niigata Rehabilitation Hospital, Niitaga, Japan.
Biomed Mater Eng. 2023;34(1):37-49. doi: 10.3233/BME-211383.
During gait, healthy knee coronal kinematics of each bony axis and lower extremity alignment are important because they could be useful as reference data for several surgeries and provide clarification of the etiology of diseases around the knee in healthy participants; however, it remains unknown.
The objective of this study was to clarify the kinematics of lower extremity alignment and the bony axes relative to the ground during gait, focused on the coronal plane, in healthy individuals by applying our unique three-dimensional (3D) motion analysis.
The study included 21 healthy individuals, including 9 healthy females and 12 healthy males with an average age of 36 ± 17 years. Knee kinematics were calculated in a gait analysis by combining the data from a motion-capture system and a 3D lower-extremity alignment assessment system on biplanar long-leg radiographs by using a 3D-2D registration technique. The main kinematic parameters were the dynamic position change relative to the ground, applying the femoral anatomical axis (FAA), tibial anatomical axis (TAA), and dynamic alignment in the coronal plane during the stance phase of gait.
The average changes in FAA, TAA, and dynamic varus alignment were 3.7° ± 1.2°, 3.5° ± 0.8°, and 3.0° ± 1.2°, respectively. The TAA tilted laterally during the loading response and a plateau area appeared afterwards; the FAA gradually inclined laterally until the terminal stance phase, and the dynamic alignment showed varus angular change during the loading response.
The tibia and femur were found to change approximately 2-5° of the position of the bony axes relative to the ground. In terms of clinical relevance, our findings can be used to clarify the etiology of diseases around the knee joint and as reference data for surgeries.
在步态中，健康膝关节冠状面的各骨骼轴和下肢对线非常重要，因为它们可以作为几种手术的参考数据，并且可以阐明健康参与者膝关节周围疾病的病因；然而，目前尚不清楚。
本研究旨在通过应用独特的三维（3D）运动分析，明确健康个体在步态中下肢对线和骨骼轴相对于地面的运动学，重点是冠状面。
本研究纳入了 21 名健康个体，包括 9 名健康女性和 12 名健康男性，平均年龄为 36±17 岁。通过使用 3D-2D 配准技术，将运动捕捉系统和双平面下肢对线评估系统在步态分析中的数据结合起来，计算膝关节运动学。主要运动学参数是相对于地面的动态位置变化，应用股骨解剖轴（FAA）、胫骨解剖轴（TAA）和冠状面动态对线在步态的站立相。
FAA、TAA 和动态内翻对线的平均变化分别为 3.7°±1.2°、3.5°±0.8°和 3.0°±1.2°。TAA 在负重反应期间向外侧倾斜，之后出现平台区；FAA 逐渐向外侧倾斜，直到终末期，动态对线在负重反应期间显示出内翻角度变化。
胫骨和股骨相对于地面的骨骼轴位置发生了约 2-5°的变化。从临床相关性来看，我们的发现可以用来阐明膝关节周围疾病的病因，并作为手术的参考数据。
