Three-dimensional in vivo motion analysis of normal knees using single-plane fluoroscopy
Three-dimensional in vivo motion analysis of normal knees using single-plane fluoroscopy
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DOI：
10.1007/s00776-011-0149-9
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发表时间：
2011-11-01
影响因子：
1.7
通讯作者：
Endo, Naoto
中科院分区：
文献类型：
--
作者：
Tanifuji, Osamu;Sato, Takashi;Endo, Naoto
分析股骨髁相对于胫骨的解剖学上确定的参考轴的运动是评估膝关节运动学的合适方法。然而，这些参数以前只在使用定格运动技术的研究中使用。本研究的目的是利用三维到二维配准技术评估正常膝关节全范围运动的体内动态运动学，并将其与先前报道的通过停止运动技术获得的正常膝关节运动学进行比较。对20名健康志愿者（10名女性，10名男性，平均年龄37.2岁）的右膝动态运动进行分析。当受试者从站立开始下蹲，膝盖完全伸展至最大屈曲时，观察膝关节运动。我们确定了以下参数：(1)几何中心轴（GCA）在胫骨轴平面上的角度变化（旋转角度）；(2) GCA内侧和外侧的前后平移；(3)膝关节屈曲各阶段的运动模式。所有受试者在膝关节屈曲期间均表现出相对于胫骨的股骨外旋（26.1A度）。股骨内侧髁从完全伸展到100A度屈曲表现出前平移（5.5 mm），在100A度屈曲后表现出后平移（3.9 mm），而股骨外侧髁在整个膝关节屈曲过程中表现出一致的后平移（15.6 mm）。所有受试者均表现出从完全伸展到近120A度屈曲的内侧枢轴运动。从120度屈曲开始，观察到双髁回滚运动。尽管我们的分析中股骨内侧髁的行为与之前的尸体研究有所不同，但采用动态分析获得的结果与之前采用定格技术获得的结果大致相同。这些结果为今后病理膝关节的动态运动学分析提供了对照数据。
Analysis of the movement of anatomically defined reference axes at the femoral condyles relative to the tibia is appropriate for evaluating knee kinematics. However, such parameters have been previously employed only in studies utilizing stop-motion techniques. The purpose of this study was to evaluate in vivo dynamic kinematics for full range of motion in normal knees using the three-dimensional to two-dimensional registration technique and to compare them with previously reported normal knee kinematics obtained via stop-motion techniques.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 when subjects squatted from standing with the knee fully extended to maximum flexion. We determined the following parameters: (1) changes to angles of the geometric center axis (GCA) on the tibial axial plane (rotation angle); (2) anteroposterior translations of the medial and lateral ends of the GCA; and (3) motion patterns in each phase during knee flexion.All subjects exhibited femoral external rotation (26.1A degrees) relative to the tibia throughout knee flexion. The medial femoral condyle demonstrated anterior translation (5.5 mm) from full extension to 100A degrees flexion, and demonstrated posterior translation (3.9 mm) after 100A degrees, while the lateral femoral condyle demonstrated consistent posterior translation (15.6 mm) throughout knee flexion. All subjects showed medial pivot motion from full extension to nearly 120A degrees flexion. From 120A degrees flexion, bicondylar rollback motion was observed.Although the behavior of the medial femoral condyle in our analysis differed somewhat from that seen in previous cadaver studies, the results obtained using dynamic analysis were generally equivalent to those obtained in previous studies employing stop-motion techniques. These results provide control data for future dynamic kinematic analyses of pathological knees.