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Screw-Home Movement of the Tibiofemoral Joint during Normal Gait: Three-Dimensional Analysis.

Kim HY, Kim KJ, Yang DS, Jeung SW, Choi HG, Choy WS - Clin Orthop Surg (2015)

Bottom Line: With respect to kinematics and kinetics, both males and females showed normal adult gait patterns, and the mean difference in the temporal gait parameters was not statistically significant (p > 0.05).Paradoxical screw-home movement may be an important mechanism that provides stability to the knee joint during the remaining stance phase.Obtaining the kinematic values of the knee joint during gait can be useful in diagnosing and treating the pathological knee joints.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.

ABSTRACT

Background: The purpose of this study was to evaluate the screw-home movement at the tibiofemoral joint during normal gait by utilizing the 3-dimensional motion capture technique.

Methods: Fifteen young males and fifteen young females (total 60 knee joints) who had no history of musculoskeletal disease or a particular gait problem were included in this study. Two more markers were attached to the subject in addition to the Helen-Hayes marker set. Thus, two virtual planes, femoral coronal plane (P f ) and tibial coronal plane (P t ), were created by Skeletal Builder software. This study measured the 3-dimensional knee joint movement in the sagittal, coronal, and transverse planes of these two virtual planes (P f and P t ) during normal gait.

Results: With respect to kinematics and kinetics, both males and females showed normal adult gait patterns, and the mean difference in the temporal gait parameters was not statistically significant (p > 0.05). In the transverse plane, the screw-home movement occurred as expected during the pre-swing phase and the late-swing phase at an angle of about 17°. However, the tibia rotated externally with respect to the femur, rather than internally, while the knee joint started to flex during the loading response (paradoxical screw-home movement), and the angle was 6°.

Conclusions: Paradoxical screw-home movement may be an important mechanism that provides stability to the knee joint during the remaining stance phase. Obtaining the kinematic values of the knee joint during gait can be useful in diagnosing and treating the pathological knee joints.

No MeSH data available.


Related in: MedlinePlus

Anteroposterior (A) and lateral (B) radiographs show that the marker was attached to the medial and lateral condyles of the femur and the tibia. The marker on the lateral tibial condyle was positioned just over the top of the fibular head while the marker on the medial tibial condyle was positioned over the bony surface on which the medial collateral ligament is inserted. It was mostly at the same level as that of the lateral tibial condyle marker.
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Figure 2: Anteroposterior (A) and lateral (B) radiographs show that the marker was attached to the medial and lateral condyles of the femur and the tibia. The marker on the lateral tibial condyle was positioned just over the top of the fibular head while the marker on the medial tibial condyle was positioned over the bony surface on which the medial collateral ligament is inserted. It was mostly at the same level as that of the lateral tibial condyle marker.

Mentions: Then, 9-mm passive reflective markers (Motion Analysis Co.) were attached by using the Helen-Hayes method,15) and additional markers were attached to the medial and lateral condyles of the proximal tibia, on which the medial and lateral collateral ligaments are attached (Fig. 1). To minimize the error while positioning the four markers on the medial and lateral condyles of the femur and tibia, the marker position was checked using C-arm fluoroscopy during the early stage of the study in all cases by an orthopaedic resident. The marker on the lateral tibial condyle was positioned just over the top of the fibular head, while the marker on the medial tibial condyle was positioned over the bony surface on which the medial collateral ligament is inserted. It was mostly at the same level as that of the lateral tibial condyle marker (Fig. 2).


Screw-Home Movement of the Tibiofemoral Joint during Normal Gait: Three-Dimensional Analysis.

Kim HY, Kim KJ, Yang DS, Jeung SW, Choi HG, Choy WS - Clin Orthop Surg (2015)

Anteroposterior (A) and lateral (B) radiographs show that the marker was attached to the medial and lateral condyles of the femur and the tibia. The marker on the lateral tibial condyle was positioned just over the top of the fibular head while the marker on the medial tibial condyle was positioned over the bony surface on which the medial collateral ligament is inserted. It was mostly at the same level as that of the lateral tibial condyle marker.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553277&req=5

Figure 2: Anteroposterior (A) and lateral (B) radiographs show that the marker was attached to the medial and lateral condyles of the femur and the tibia. The marker on the lateral tibial condyle was positioned just over the top of the fibular head while the marker on the medial tibial condyle was positioned over the bony surface on which the medial collateral ligament is inserted. It was mostly at the same level as that of the lateral tibial condyle marker.
Mentions: Then, 9-mm passive reflective markers (Motion Analysis Co.) were attached by using the Helen-Hayes method,15) and additional markers were attached to the medial and lateral condyles of the proximal tibia, on which the medial and lateral collateral ligaments are attached (Fig. 1). To minimize the error while positioning the four markers on the medial and lateral condyles of the femur and tibia, the marker position was checked using C-arm fluoroscopy during the early stage of the study in all cases by an orthopaedic resident. The marker on the lateral tibial condyle was positioned just over the top of the fibular head, while the marker on the medial tibial condyle was positioned over the bony surface on which the medial collateral ligament is inserted. It was mostly at the same level as that of the lateral tibial condyle marker (Fig. 2).

Bottom Line: With respect to kinematics and kinetics, both males and females showed normal adult gait patterns, and the mean difference in the temporal gait parameters was not statistically significant (p > 0.05).Paradoxical screw-home movement may be an important mechanism that provides stability to the knee joint during the remaining stance phase.Obtaining the kinematic values of the knee joint during gait can be useful in diagnosing and treating the pathological knee joints.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.

ABSTRACT

Background: The purpose of this study was to evaluate the screw-home movement at the tibiofemoral joint during normal gait by utilizing the 3-dimensional motion capture technique.

Methods: Fifteen young males and fifteen young females (total 60 knee joints) who had no history of musculoskeletal disease or a particular gait problem were included in this study. Two more markers were attached to the subject in addition to the Helen-Hayes marker set. Thus, two virtual planes, femoral coronal plane (P f ) and tibial coronal plane (P t ), were created by Skeletal Builder software. This study measured the 3-dimensional knee joint movement in the sagittal, coronal, and transverse planes of these two virtual planes (P f and P t ) during normal gait.

Results: With respect to kinematics and kinetics, both males and females showed normal adult gait patterns, and the mean difference in the temporal gait parameters was not statistically significant (p > 0.05). In the transverse plane, the screw-home movement occurred as expected during the pre-swing phase and the late-swing phase at an angle of about 17°. However, the tibia rotated externally with respect to the femur, rather than internally, while the knee joint started to flex during the loading response (paradoxical screw-home movement), and the angle was 6°.

Conclusions: Paradoxical screw-home movement may be an important mechanism that provides stability to the knee joint during the remaining stance phase. Obtaining the kinematic values of the knee joint during gait can be useful in diagnosing and treating the pathological knee joints.

No MeSH data available.


Related in: MedlinePlus