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Title: In vivo six-degree-of-freedom knee-joint kinematics in overground and treadmill walking following total knee arthroplasty.
Authors: Feller, Julian
de Steiger, Richard
Other Authors: Guan, Shanyuanye
Gray, Hans
Schache, Anthony
Pandy, Marcus
Keywords: Joint Replacement
Total Knee Arthroplasty
Knee Replacement
Internal Prosthesis
Implant Wear
Knee-Joint Kinematics
Joint Loading
Knee Implant Performance
Biplane X-ray Fluoroscopy
Artificial Knee Performance
Department of Surgery, Epworth Health Care, Victoria, Australia
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Aug-2017
Publisher: Wiley
Citation: J Orthop Res. 2017 Aug;35(8):1634-1643
Abstract: No data are available to describe six-degree-of-freedom (6-DOF) knee-joint kinematics for one complete cycle of overground walking following total knee arthroplasty (TKA). The aims of this study were firstly, to measure 6-DOF knee-joint kinematics and condylar motion for overground walking following TKA; and secondly, to determine whether such data differed between overground and treadmill gait when participants walked at the same speed during both tasks. A unique mobile biplane X-ray imaging system enabled accurate measurement of 6-DOF TKA knee kinematics during overground walking by simultaneously tracking and imaging the joint. The largest rotations occurred for flexion-extension and internal-external rotation whereas the largest translations were associated with joint distraction and anterior-posterior drawer. Strong associations were found between flexion-extension and adduction-abduction (R2  = 0.92), joint distraction (R2  = 1.00), and anterior-posterior translation (R2  = 0.77), providing evidence of kinematic coupling in the TKA knee. Although the measured kinematic profiles for overground walking were grossly similar to those for treadmill walking, several statistically significant differences were observed between the two conditions with respect to temporo-spatial parameters, 6-DOF knee-joint kinematics, and condylar contact locations and sliding. Thus, caution is advised when making recommendations regarding knee implant performance based on treadmill-measured knee-joint kinematic data.
DOI: 10.1002/jor.23466
PubMed URL:
ISSN: 1554-527X
Journal Title: Journal of Orthopaedic Research
Type: Journal Article
Affiliated Organisations: Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia.
Type of Clinical Study or Trial: Observational Study
Appears in Collections:Musculoskeletal

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