Non-invasive quantification of knee kinematics: a cadaver study

QM Human anatomy;RD Surgery;RZ Other systems of medicine

Russell, David F. ; Fogg, Quentin

University:University of Glasgow

Department:School of Medicine, Dentistry & Nursing

关键词: Kinematics, Knee, Orthopaedic surgery, total knee replacement, anterior cruciate ligament reconstruction, collateral ligament reconstruction, tibial rotation, cadaveric, non-invasive, image-free computer assisted orthopaedic surgery, navigated surgery;   

Others  :  http://theses.gla.ac.uk/6300/8/2015RussellMD.pdf

来源: University of Glasgow

【 摘 要 】

The ability to quantify kinematic parameters of the knee is crucial in understanding normalbiomechanics, recognising the presence of pathology and its severity, planning treatmentand evaluation of outcomes. Current methods of quantifying lower limb kinematicsremain limited in allowing accurate dynamic assessment. Computer assisted surgerysystems have been validated in quantifying kinematic parameters, but remain limited to theoperative setting. Recently, image-free computer assisted surgery technology has beenadapted for non-invasive use and validated in terms of repeatability in measuring coronaland sagittal femorotibial mechanical alignment in extension. The aim of this thesis was todevelop and implement a set of validation protocols to quantify the reliability, precisionand accuracy of this non-invasive technology in quantifying lower limb coronal andsagittal femorotibial mechanical alignment, anteroposterior and rotatory laxity of the kneeby comparison with a validated, commercially available image-free computer assistedsurgery system.Pilot study confirmed feasibility of further experimental work and revealed that the noninvasivemethod measured with satisfactory precision and accuracy: coronal mechanicalfemorotibial alignment (MFTA) from extension to 30° knee flexion, anteroposteriortranslation in extension and tibial rotatory laxity during flexion.Further experiments using 12 fresh cadaveric limbs revealed that the non-invasive methodgave satisfactory precision and agreement with the invasive system measuring MFTAwithout stress from extension to 40° knee flexion, and with 15Nm coronal stress fromextension to 30° knee flexion. Using 100N of anterior force on the tibia, the non-invasivesystem was acceptably precise and accurate in measuring sagittal tibial displacement fromextension to 40° flexion. End of range apprehension, such as has been proven repeatable inmeasuring tibial rotatory laxity was used and the non-invasive method gave superior3precision and accuracy to most reported non-invasive devices in quantifying tibial rotatoryrange of motion.Non-invasive optical tracking systems provide a means to quantify important kinematicparameters in health and disease, and could allow standardisation of knee examinationincreasing communicability and translation of findings from the out-patient to operativesetting. This technology therefore could allow restoration of individual specific kinematicsin knee arthroplasty and soft-tissue reconstruction.