Three-dimensional motion analysis of the human knee joint: comparison between intra- and post-operative measurements

Knee Surg Sports Traumatol Arthrosc. 2013 Oct;21(10):2375-83. doi: 10.1007/s00167-012-2271-4. Epub 2012 Nov 2.

Abstract

Purpose: To compare intra-operative knee joint kinematic measurements immediately after total knee replacement with those of the same patients post-operatively at 6-month follow-up.

Methods: Fifteen patients who underwent total knee arthroplasty were analysed retrospectively. Eight were implanted with one prosthesis design and seven with another. The intra-operative measurements were performed by using a standard knee navigation system. This provided accurate three-dimensional positions and orientations for the femur and tibia by corresponding trackers pinned into the bones. At 6-month follow-up, the patients were analysed by standard three-dimensional video-fluoroscopy of the replaced knee during stair climbing, chair rising and step-up. Relevant three-dimensional positions and orientations were obtained by an iterative shape-matching procedure between the silhouette contours and the CAD-model projections. A number of traditional kinematic parameters were calculated from both measurements to represent the joint motion.

Results: Good post-operative replication of the intra-operative measurements was observed for most of the variables analysed. The statistical analysis also supported the good consistency between the intra- and post-operative measurements.

Conclusions: Intra-operative kinematic measurements, accessible by a surgical navigation system, are predictive of the following motion performance of the replaced knees as experienced in typical activities of daily living.

Level of evidence: Prognostic studies--investigating natural history and evaluating the effect of a patient characteristic, Level II.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / instrumentation
  • Arthroplasty, Replacement, Knee / methods*
  • Biomechanical Phenomena
  • Fluoroscopy
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional*
  • Intraoperative Period
  • Knee Joint / diagnostic imaging
  • Knee Joint / physiopathology*
  • Knee Joint / surgery
  • Knee Prosthesis
  • Middle Aged
  • Outcome Assessment, Health Care
  • Postoperative Period
  • Range of Motion, Articular*
  • Retrospective Studies
  • Surgery, Computer-Assisted / instrumentation
  • Surgery, Computer-Assisted / methods*
  • Video Recording