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von Eisenhart-Rothe, R.* ; Vogl, T.* ; Englmeier, K.-H. ; Graichen, H.*

A new in vivo technique for determination of femoro-tibial and femoro-patellar 3D kinematics in total knee arthroplasty.

J. Biomech. 40, 3079-3088 (2007)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
Aim was to develop an in vivo technique which allows determination of femoro-tibial and of femoro-patellar 3D-kinematics in TKA simultaneously. The knees of 20 healthy volunteers and of eight patients with TKA (PCR, rotating platform) were investigated. Kinematics analysis was performed in an open MR-system at different flexion angles with external loads being applied. The TKA components were identified using a 3D-fitting technique, which allows an automated 3D-3D-registration of the TKA. Femoro-patellar and femoro-tibial 3D-kinematics were analyzed by image postprocessing. The validity of the postprocessing technique demonstrated a coefficient of determination of 0.98 for translation and of 0.97 for rotation. The reproducibility yielded a coefficient of variation (CV%) for patella kinematics between 0.17% (patello-femoral angle) and 6.8% (patella tilt). The femoro-tibial displacement also showed a high reproducibility with CV% of 4.0% for translation and of 7.1% for rotation. While in the healthy knees the typical screw-home mechanism was observed, a paradoxical anterior translation of the femur relative to the tibia combined with an external rotation occurred after TKA. Fifty percent of the TKA's experienced a condylar lift-off of >1mm predominately on the medial side. Regarding patellar kinematics significant changes were found in both planes in TKA with an increased patella height in the sagittal plane and patella tilt and shift in the transversal plane. The results demonstrate that the presented 3D MR-open based method is highly reproducible and valid for image acquisition and postprocessing and provides-for the first time-in vivo data of 3D-kinematics of the tibio-femoral and simultaneously of the patello-femoral joint during knee flexion.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Knee; Kinematics; TKA; Open MR imaging
ISSN (print) / ISBN 0021-9290
e-ISSN 1873-2380
Quellenangaben Volume: 40, Issue: 14, Pages: 3079-3088 Article Number: , Supplement: ,
Publisher Elsevier
Non-patent literature Publications
Reviewing status Peer reviewed