scholarly journals In-vivo patellar tendon kinematics during weight-bearing deep knee flexion

2012 ◽  
Vol 30 (10) ◽  
pp. 1596-1603 ◽  
Author(s):  
Koichi Kobayashi ◽  
Makoto Sakamoto ◽  
Ali Hosseini ◽  
Harry E. Rubash ◽  
Guoan Li
2013 ◽  
Vol 135 (8) ◽  
Author(s):  
Koichi Kobayashi ◽  
Ali Hosseini ◽  
Makoto Sakamoto ◽  
Wei Qi ◽  
Harry E. Rubash ◽  
...  

While various factors have been assumed to affect knee joint biomechanics, few data have been reported on the function of the extensor mechanism in deep flexion of the knee. This study analyzed the patellofemoral joint contact kinematics and the ratio of the quadriceps and patellar tendon forces in living subjects when they performed a single leg lunge up to 150 deg of flexion. The data revealed that in the proximal-distal direction, the patellofemoral articular contact points were in the central one-third of the patellar cartilage. Beyond 90 deg of flexion, the contact points moved towards the medial-lateral edges of the patellar surface. At low flexion angles, the patellar tendon and quadriceps force ratio was approximately 1.0 but reduced to about 0.7 after 60 deg of knee flexion, implying that the patella tendon carries lower loads than the quadriceps. These data may be valuable for improvement of contemporary surgical treatments of diseased knees that are aimed to achieve deep knee flexion.


2005 ◽  
Vol 23 (2) ◽  
pp. 340-344 ◽  
Author(s):  
Guoan Li ◽  
Louis E. DeFrate ◽  
Harry E. Rubash ◽  
Thomas J. Gill

Author(s):  
Chadd W. Clary ◽  
Amit M. Mane ◽  
Amber N. Reeve ◽  
Kevin A. Dodd ◽  
Lorin P. Maletsky

Understanding the behavior of the natural knee in deep flexion can offer insight into the necessary design characteristics of a total knee implant. Andriacchi et al. [1] measured the in vivo characteristics of knee motion down to ∼150° knee flexion during a weight bearing squat. Likewise, Li et al. [2] investigated deep knee flexion in vitro using robotic technology during passive knee flexion. Both of these studies offer insight into the behavior of the knee in deep knee flexion; however, they have some limitations with regards to assessing physiological activities in a controlled manner. The purpose of this study was to measure the kinematics of the knee during a simulated in vitro deep knee squat so that in the future a dynamic, load-bearing, simulated deep knee squat could be used as a tool in the design of total knee prostheses.


2010 ◽  
Vol 132 (6) ◽  
Author(s):  
Kartik M. Varadarajan ◽  
Andrew A. Freiberg ◽  
Thomas J. Gill ◽  
Harry E. Rubash ◽  
Guoan Li

It is widely recognized that the tracking of patella is strongly influenced by the geometry of the trochlear groove. Nonetheless, quantitative baseline data regarding correlation between the three-dimensional geometry of the trochlear groove and patellar tracking under in vivo weight-bearing conditions are not available. A combined magnetic resonance and dual fluoroscopic imaging technique, coupled with multivariate regression analysis, was used to quantify the relationship between trochlear groove geometry (sulcus location, bisector angle, and coronal plane angle) and in vivo patellar tracking (shift, tilt, and rotation) during weight-bearing knee flexion. The results showed that in the transverse plane, patellar shift was strongly correlated (correlation coefficient R=0.86, p<0.001) to mediolateral location of the trochlear sulcus (raw regression coefficient βraw=0.62) and the trochlear bisector angle (βraw=0.31). Similarly, patellar tilt showed a significant association with the trochlear bisector angle (R=0.45, p<0.001, and βraw=0.60). However, in the coronal plane patellar rotation was poorly correlated with its matching geometric parameter, namely, the coronal plane angle of the trochlea (R=0.26, p=0.01, βraw=0.08). The geometry of the trochlear groove in the transverse plane of the femur had significant effect on the transverse plane motion of the patella (patellar shift and tilt) under in vivo weight-bearing conditions. However, patellar rotation in the coronal plane was weakly correlated with the trochlear geometry.


2007 ◽  
Vol 40 (8) ◽  
pp. 1716-1722 ◽  
Author(s):  
Louis E. DeFrate ◽  
Kyung Wook Nha ◽  
Ramprasad Papannagari ◽  
Jeremy M. Moses ◽  
Thomas J. Gill ◽  
...  

2013 ◽  
Vol 29 (10) ◽  
pp. 1653-1660 ◽  
Author(s):  
Sebastien Lustig ◽  
Corey J. Scholes ◽  
Jean-Christian Balestro ◽  
David A. Parker

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tong Liu ◽  
Xianyue Shen ◽  
Qingming Ji ◽  
Jianlin Xiao ◽  
Jianlin Zuo ◽  
...  

AbstractThere are few studies investigate morphologic changes of knee meniscus in vivo mechanical loading and three-dimensions (3D) deformation and displacement of the whole meniscus between in vivo mechanical loading and unloading conditions are still unclear. To investigate the displacements and 3D morphological changes of the menisci under knee weight-bearing and early flexion conditions in healthy adults using a Magnetic Resonance Imaging (MRI)-compatible loading device (a 3.0 T MR imaging system) combined with a newly developed 3D comparison technique. Fifteen healthy volunteers were recruited in this cross-sectional observational study. Each subject underwent MRIs of their dominant right knee in eight different scanning conditions using a 3.0-T MRI scanner with a custom-made MRI-compatible loading device. The knee meniscus images were 3D reconstructed, and dimensional comparisons were made for each meniscal model with baseline (0°-unloaded model). The morphologic changes of the meniscal-anterior horn (AH), body (BD), and posterior horn (PH) regions were expressed as mean positive and negative deviations. The displacements were further investigated, and the meniscal extrusions of different subregions were measured. The morphologic changing patterns of human meniscus under loading and flexions were presented using 3D chromatic maps. The bilateral menisci were generally shifting laterally and posteriorly in most flexion angles and were changing medially and anteriorly under fully extended knee loading conditions. The mean deviations were more significant with loading at 0° of knee flexion, while the PH region in the lateral side changed further posteriorly with loading in 30° flexion. Most of the differences were not significant in other flexion angles between loading conditions. The extrusion of meniscus’s medial body was greater in full extension compared to any other flexing angles. Mechanical loading can significantly deform the menisci in knee extension; however, this effect is limited during knee flexion. Current study can be used as a reference for the evaluations of the integrity in meniscal functions.


2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0014
Author(s):  
Dariusz Straszewski ◽  
Marcin Plenzler ◽  
Joanna Szczepaniak ◽  
Robert Śmigielski ◽  
Beata Ciszkowska-Łysoń ◽  
...  

Objectives: The aim of the study was to asses the impact of the functional rehabilitation on patella alignment with MRI imaging in patients who underwent the ACL reconstruction. The surgical approach with the use of patellar tendon graft is known to carry the risk of lowering patella height (patella baja), which, in turn, may lead to accelerated cartilage wear in patellofemoral joint. Methods: 30 patients after the anatomical reconstruction of ACL took part in this study (23 male, and 7 female, mean age = 28 ± 10,6 years). During the procedure a patellar tendon graft was used. The Insali-Salvati ratio measured with MRI (images taken pre-procedural, and 9 months after the surgery) was used for the assessment of patellar alignment. The measurements were taken by one radiology specialist on MRI scans in sagittal view in PD sequence. During the examination, patellar joint was in flexion (approx.10 degrees). As the point of reference for patella’s position ISR ratio was in the range of 0.8 - 1.2. All patients were operated on by the same team of surgeons and underwent an unified rehabilitation programme led by a team of selected physiotherapists. The main features of the programme were: an early muscle activation (second day after the procedure); mobilisation of the patella and tissues of the anterior compartment of the knee; weight bearing co-contraction exercises, and the sensomotoric training of the entire kinetic chain of the lower limb. The data recorded was statistically analysed using the Wilcoxon signed-rank test in order to establish parameters’ changes within the study group.. Results: The mean ISR value before the procedure was 0.84 (± 0,1), whereas 9 months after the surgery it was 0.85 (± 0,1). The results’ analysis did not show any statistically significant changes between ISR values. Nine months after the procedure patella baja has not been observed in any of the evaluated patients. Conclusion: The functional rehabilitation programme designed by the CMC team had no negative impact on patella alignment, as no patella baja, which is a common complication after these kinds of surgeries, has been observed. The applied functional rehabilitation programme enabled patients to keep the proper patella alignment, similar to the alignment recorded before the surgery.


2005 ◽  
Vol 15 (3) ◽  
pp. 167-171 ◽  
Author(s):  
Christopher R Carcia ◽  
Sandra J Shultz ◽  
Kevin P Granata ◽  
David H Perrin ◽  
RobRoy L Martin
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