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Investigation of Characteristic Motion Patterns of the Knee Joint During a Weightbearing Flexion

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Abstract

This study aimed to develop and validate a novel flexion axis concept by calculating the points on femoral condyles that could maintain constant heights during knee flexion. Twenty-two knees of 22 healthy subjects were investigated when performing a weightbearing single leg lunge. The knee positions were captured using a validated dual fluoroscopic image system. The points on sagittal planes of the femoral condyles that had minimal changes in heights from the tibial plane along the flexion path were calculated. It was found that the points do formulate a medial-lateral flexion axis that was defined as the iso-height axis (IHA). The six degrees of freedom (6DOF) kinematics data calculated using the IHA were compared with those calculated using the conventional transepicondylar axis and geometrical center axis. The IHA measured minimal changes in proximal–distal translations and varus–valgus rotations along the flexion path, indicating that the IHA may have interesting clinical implications. Therefore, identifying the IHA could provide an alternative physiological reference for improvement of contemporary knee surgeries, such as ligament reconstruction and knee replacement surgeries that are aimed to reproduce normal knee kinematics and medial/lateral soft tissue tensions during knee flexion.

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Funding

This work was supported by the National Institutes of Health (R01AR055612), the Department of Orthopaedic Surgery at Newton-Wellesley Hospital, the Jiangsu provincial government scholarship program, and the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD).

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Authors and Affiliations

  1. Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital/Massachusetts General Brigham, Newton, MA, 02462, USA

    Jia Yu, Yulian Xia, Chaochao Zhou, Tsungyuan Tsai, Sophia Li, Timothy Foster, Hany Bedair & Guoan Li

  2. Department of Orthopaedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Jia Yu & Hany Bedair

  3. Orthopaedic Institute, Soochow Medical College, Soochow University, Suzhou, Jiangsu, China

    Jia Yu

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  1. Jia Yu
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Contributions

JY, CZ, HB, and GL designed the study. YX performed statistical analysis of the data. JY, YX, CZ, TT, and SL performed the data collection, analysis, and assisting in paper writing. JY, YX, TF, HB, and GL interpreted the data and drafted the manuscript. All authors edited, revised, and approved the final version. GL was the chief investigator for the study.

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Correspondence to Guoan Li.

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Associate Editor Andreas Anayiotos oversaw the review of this article.

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Yu, J., Xia, Y., Zhou, C. et al. Investigation of Characteristic Motion Patterns of the Knee Joint During a Weightbearing Flexion. Ann Biomed Eng 51, 2237–2244 (2023). https://doi.org/10.1007/s10439-023-03259-1

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  • DOI: https://doi.org/10.1007/s10439-023-03259-1

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