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Three-dimensional in vivo motion analysis of normal knees employing transepicondylar axis as an evaluation parameter

Knee Surgery, Sports Traumatology, Arthroscopy volume 21, pages 2301–2308 (2013)Cite this article

Abstract

Purpose

The transepicondylar axis (TEA) has been used as a flexion axis of the knee and a reference of the rotational alignment of the femoral component. However, no study has showed dynamic normal knee kinematics employing TEA as the evaluation parameter throughout the full range of motion in vivo. The purpose of this study was to analyze dynamic kinematics of the normal knee through the full range of motion via the 3-dimensional to 2-dimensional registration technique employing TEA as the evaluation parameter.

Methods

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 as subjects squatted from standing with knee fully extended to maximum flexion. The following parameters were determined: (1) Anteroposterior translations of the medial and lateral ends of the TEA; and (2) changes in the angle of the TEA on the tibial axial plane (rotation angle).

Results

The medial end of the TEA demonstrated anterior translation (3.6 ± 3.0 mm) from full extension to 30° flexion and demonstrated posterior translation (18.1 ± 3.7 mm) after 30°, while the lateral end of the TEA demonstrated consistent posterior translation (31.1 ± 7.3 mm) throughout knee flexion. All subjects exhibited femoral external rotation (16.9 ± 6.2°) relative to the tibia throughout knee flexion.

Conclusion

Compared to previously used parameters, the TEA showed bicondylar posterior translation from early flexion phase. These results provide control data for dynamic kinematic analyses of pathologic knees in the future and will be useful in the design of total knee prostheses.

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Acknowledgments

The authors would like to thank the entire staff of the Department of Radiology of the Niigata University Medical and Dental Hospital for their technical support and cooperation and Steve Lenio for his cooperation.

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Affiliations

  1. Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medicine and Dental Science, 757 Asahimachi-dori 1, Niigata, Niigata, 951-8510, Japan

    Osamu Tanifuji, Tomoharu Mochizuki, Hiroshi Yamagiwa & Naoto Endo

  2. Department of Orthopaedic Surgery, Niigata Medical Center, Niigata, Japan

    Osamu Tanifuji, Takashi Sato & Yoshio Koga

  3. Department of Health Sciences, Niigata University School of Medicine, Niigata, Japan

    Koichi Kobayashi

  4. Center for Transdisciplinary Research, Institute for Research Promotion, Niigata University, Niigata, Japan

    Go Omori

Authors
  1. Osamu Tanifuji
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  2. Takashi Sato
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  3. Koichi Kobayashi
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  4. Tomoharu Mochizuki
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  5. Yoshio Koga
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  6. Hiroshi Yamagiwa
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  7. Go Omori
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  8. Naoto Endo
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Corresponding author

Correspondence to Osamu Tanifuji.

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Tanifuji, O., Sato, T., Kobayashi, K. et al. Three-dimensional in vivo motion analysis of normal knees employing transepicondylar axis as an evaluation parameter. Knee Surg Sports Traumatol Arthrosc 21, 2301–2308 (2013). https://doi.org/10.1007/s00167-012-2010-x

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  • DOI: https://doi.org/10.1007/s00167-012-2010-x

Keywords

  • Normal knee
  • Transepicondylar axis
  • Knee kinematics
  • Fluoroscopy
  • In vivo kinematics
  • 3-dimensional to 2-dimensional registration technique