Abstract
The purpose of this study was to estimate and compare the moment arm length of the patellar tendon (d) during passive knee extension using three different reference landmarks; instant centre of rotation (ICR), tibiofemoral contact point (TFCP) and geometrical centre of the posterior femoral condyles (GCFC). Measurements were taken on the right leg on seven healthy males during passive knee rotation performed by the motor of a Cybex Norm isokinetic dynamometer. Moment arms lengths were obtained by analysing lateral X-ray images recorded using a GE FlexiView 8800 C-arm videofluoroscopy system. The d–knee joint angle relations with respect to GCFC and ICR were similar, with decreasing values from full knee extension (~5.8 cm for d GCFC and ~5.9 cm for d ICR) to 90° of knee flexion (~4.8 cm for both d GCFC and d ICR). However, the d TFCP–knee joint angle relation had an ascending–descending shape, with the highest d TFCP value (~5 cm) at 60° of knee flexion. There was no significant difference between the GCFC and ICR methods at any knee joint angle. In contrast, there were significant differences (P < 0.01) between d ICR and d TFCP at 0°, 15°, 30° and 45° of knee flexion and between d GCFC and d TFCP at 0°, 15° and 30° of knee flexion (P < 0.01). This study shows that when using different knee joint rotation centre definitions, there are significant differences in the estimates of the patellar tendon moment arm length, especially in more extended knee joint positions. These differences can have serious implications for joint modelling and loading applications.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Baltzopoulos V (1995) A videofluoroscopy method for optical distortion correction and measurement of knee-joint kinematics. Clin Biomech (Bristol, Avon) 10:85–92. doi:10.1016/0268-0033(95)92044-M
Buford WL Jr, Ivey FM Jr, Malone JD, Patterson RM, Peare GL, Nguyen DK, Stewart AA (1997) Muscle balance at the knee—moment arms for the normal knee and the ACL-minus knee. IEEE Trans Rehabil Eng 5:367–379. doi:10.1109/86.650292
Challis JH (2001) Estimation of the finite center of rotation in planar movements. Med Eng Phys 23:227–233. doi:10.1016/S1350-4533(01)00043-1
Chow JW, Park SA, Wight JT, Tillman MD (2006) Reliability of a technique for determining sagittal knee geometry from lateral knee radiographs. Knee 13:318–323. doi:10.1016/j.knee.2006.02.008
Churchill DL, Incavo SJ, Johnson CC, Beynnon BD (1998) The transepicondylar axis approximates the optimal flexion axis of the knee. Clin Orthop Relat Res 356:111–118. doi:10.1097/00003086-199811000-00016
Crisco JJ 3rd, Chen X, Panjabi MM, Wolfe SW (1994) Optimal marker placement for calculating the instantaneous center of rotation. J Biomech 27:1183–1187. doi:10.1016/0021-9290(94)90059-0
Eckhoff DG, Bach JM, Spitzer VM, Reinig KD, Bagur MM, Baldini TH, Rubinstein D, Humphries S (2003) Three-dimensional morphology and kinematics of the distal part of the femur viewed in virtual reality. Part II. J Bone Joint Surg Am 85-A(Suppl 4):97–104
Eckhoff DG, Dwyer TF, Bach JM, Spitzer VM, Reinig KD (2001) Three-dimensional morphology of the distal part of the femur viewed in virtual reality. J Bone Joint Surg Am 83-A(Suppl 2):43–50
Fantozzi S, Cappello A, Leardini A (2003) A global method based on thin-plate splines for correction of geometric distortion: an application to fluoroscopic images. Med Phys 30:124–131. doi:10.1118/1.1538228
Freeman MA, Pinskerova V (2005) The movement of the normal tibio-femoral joint. J Biomech 38:197–208. doi:10.1016/j.jbiomech.2004.02.006
Hollister AM, Jatana S, Singh AK, Sullivan WW, Lupichuk AG (1993) The axes of rotation of the knee. Clin Orthop Relat Res 290:259–268
Kellis E, Baltzopoulos V (1999a) The effects of the antagonist muscle force on intersegmental loading during isokinetic efforts of the knee extensors. J Biomech 32:19–25. doi:10.1016/S0021-9290(98)00131-6
Kellis E, Baltzopoulos V (1999b) In vivo determination of the patella tendon and hamstrings moment arms in adult males using videofluoroscopy during submaximal knee extension and flexion. Clin Biomech (Bristol, Avon) 14:118–124. doi:10.1016/S0268-0033(98)00055-2
Krevolin JL, Pandy MG, Pearce JC (2004) Moment arm of the patellar tendon in the human knee. J Biomech 37:785–788. doi:10.1016/j.jbiomech.2003.09.010
Maganaris CN, Baltzopoulos V, Ball D, Sargeant AJ (2001) In vivo specific tension of human skeletal muscle. J Appl Physiol 90:865–872
McCane B, Abbott JH, King T (2005) On calculating the finite centre of rotation for rigid planar motion. Med Eng Phys 27:75–79. doi:10.1016/j.medengphy.2004.08.010
Moorehead JD, Montgomery SC, Harvey DM (2003) Instant center of rotation estimation using the Reuleaux technique and a lateral extrapolation technique. J Biomech 36:1301–1307. doi:10.1016/S0021-9290(03)00156-8
Most E, Axe J, Rubash H, Li G (2004) Sensitivity of the knee joint kinematics calculation to selection of flexion axes. J Biomech 37:1743–1748. doi:10.1016/j.jbiomech.2004.01.025
Nisell R (1985) Mechanics of the knee. A study of joint and muscle load with clinical applications. Acta Orthop Scand Suppl 216:1–42
Nisell R, Nemeth G, Ohlsen H (1986) Joint forces in extension of the knee. Analysis of a mechanical model. Acta Orthop Scand 57:41–46
Panjabi MM (1979) Centers and angles of rotation of body joints: a study of errors and optimization. J Biomech 12:911–920. doi:10.1016/0021-9290(79)90059-9
Panjabi MM, Goel VK, Walter SD (1982a) Errors in kinematic parameters of a planar joint: guidelines for optimal experimental design. J Biomech 15:537–544. doi:10.1016/0021-9290(82)90007-0
Panjabi MM, Goel VK, Walter SD, Schick S (1982b) Errors in the center and angle of rotation of a joint: an experimental study. J Biomech Eng 104:232–237
Rees JL, Price AJ, Beard DJ, Robinson BJ, Murray DW (2002) Defining the femoral axis on lateral knee fluoroscopy. Knee 9:65–68. doi:10.1016/S0968-0160(01)00132-6
Robinson BJ, Rees JL, Price AJ, Beard DJ, Murray DM (2002) A kinematic study of lateral unicompartmental arthroplasty. Knee 9:237. doi:10.1016/S0968-0160(02)00039-X
Sheehan FT (2007) The 3D patellar tendon moment arm: quantified in vivo during volitional activity. J Biomech 40(9):1968–1974
Smidt GL (1973) Biomechanical analysis of knee flexion and extension. J Biomech 6:79–92. doi:10.1016/0021-9290(73)90040-7
Spiegelman JJ, Woo SL (1987) A rigid-body method for finding centers of rotation and angular displacements of planar joint motion. J Biomech 20:715–721. doi:10.1016/0021-9290(87)90037-6
Tsaopoulos DE, Baltzopoulos V, Maganaris CN (2006a) Human patellar tendon moment arm length: measurement considerations and clinical implications for joint loading assessment. Clin Biomech (Bristol, Avon) 21:657–667. doi:10.1016/j.clinbiomech.2006.02.009
Tsaopoulos DE, Maganaris CN, Baltzopoulos V (2006b) Can the patellar tendon moment arm be predicted from anthropometric measurements? J Biomech 40(3):645–651
Tsaopoulos DE, Baltzopoulos V, Richards PJ, Maganaris CN (2007) In vivo changes in the human patellar tendon moment arm length with different modes and intensities of muscle contraction. J Biomech 40:3325–3332. doi:10.1016/j.jbiomech.2007.05.005
Yamaguchi GT, Zajac FE (1989) A planar model of the knee joint to characterize the knee extensor mechanism. J Biomech 22:1–10. doi:10.1016/0021-9290(89)90179-6
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tsaopoulos, D.E., Baltzopoulos, V., Richards, P.J. et al. A comparison of different two-dimensional approaches for the determination of the patellar tendon moment arm length. Eur J Appl Physiol 105, 809–814 (2009). https://doi.org/10.1007/s00421-008-0968-3
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-008-0968-3