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Four-dimensional computed tomographic analysis of screw home movement in patients with anterior cruciate ligament deficient knee — a 3D-3D registration technique

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Abstract

Objective

The tibia externally rotates to the femur during the last 20° of the knee extension motion. This kinematic phenomenon is well known as screw home movement (SHM). The purpose was to clarify the SHM in anterior cruciate ligament deficient (ACLD) knee using four-dimensional computed tomography (4DCT).

Materials and methods

Six patients with a unilateral isolated ACLD knee participated. In the static position, CT scan of the both limbs of the femur and tibia were performed. Then, 4DCT was performed around knee. In the CT gantry, subjects were positioned in supine position with 45° of knee flexion on a triangle pillow and were asked to extend the knee to full extension within 10 s on each limb. The CT data were accumulated in digital imaging and communication in medicine (DICOM) data format. From the static CT and 4DCT DICOM data, three-dimensional surfaces of the knee joint were reconstructed. The whole tibia surface was matched into the partial tibia surface of that frame using 3D-3D registration technique. After the assessment of coordination system of the whole leg, knee flexion, abduction, and external rotation angle were calculated.

Results

Knee external rotation angle was significantly smaller on the ACLD side than on the contralateral unaffected side in 0–15° of knee flexion (P < 0.05 in 0, 5, 10, and 15 degrees), while the angle was similar during 15–60° of knee flexion.

Conclusion

The absence of SHM in ACLD knee was detected using 3D-3D registration technique based on 4DCT.

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Acknowledgements

The authors would like to thank Prof. Morio Matsumoto, MD, PhD and Shu Kobayashi, MD, PhD from Department of Orthopedic Surgery, Keio University School of Medicine for clinical advice. Further support was provided by Sumi Yamashita and Hiroko Arai of Department of Clinical Biomechanics, Keio University School of Medicine.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Yutaro Morishige, Kengo Harato, Kazuya Kaneda, Yasuo Niki, Masaya Nakamura & Takeo Nagura

  2. Department of Clinical Biomechanics, Keio University School of Medicine, Tokyo, Japan

    Yutaro Morishige, Kengo Harato, Satoshi Oki, Kazuya Kaneda & Takeo Nagura

Authors
  1. Yutaro Morishige
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  2. Kengo Harato
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  3. Satoshi Oki
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  4. Kazuya Kaneda
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  5. Yasuo Niki
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  6. Masaya Nakamura
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  7. Takeo Nagura
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Contributions

Yutaro Morishige contributed to the acquisition and analysis of data and to the writing of the manuscript. Kengo Harato contributed to the conception and design of the work, to the analysis of the results, and to the writing of the manuscript revision. Satoshi Oki contributed to the programing of 3D-3D surface registration. Kazuya Kaneda contributed to the analysis of data. Yasuo Niki contributed to the interpretation of the results. Masaya Nakamura contributed to the organization of the work and research member. Takeo Nagura contributed to the interpretation of data and to the final version of the manuscript.

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Correspondence to Kengo Harato.

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Morishige, Y., Harato, K., Oki, S. et al. Four-dimensional computed tomographic analysis of screw home movement in patients with anterior cruciate ligament deficient knee — a 3D-3D registration technique. Skeletal Radiol 51, 1679–1685 (2022). https://doi.org/10.1007/s00256-021-03986-3

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  • DOI: https://doi.org/10.1007/s00256-021-03986-3

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