Limits...
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

These graphs show kinematics of the knee joint during gait. (A) While the knee joint was flexed approximately 15° during the loading response, the tibia was externally rotated around the femur about 6° (green line and black arrow). (B) This amount of tibial rotation was maintained during the mid-stance phase (green line and black arrow). (C) As the knee reached full extension in the late-swing phase, the tibia was then rotated externally by 17°; thus, it almost reached the neutral position (green line and black arrow). Rz: rotational degrees in the sagittal plane, negative value is the extension angle and positive value is the flexion angle, Rx: rotational degrees in the coronal plane, negative value is the extension angle and positive value is the flexion angle, negative value is the valgus angle and positive value is the varus angle, Ry: rotational degrees in the transverse plane, negative value is the external rotation angle and positive value is the internal rotation angle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4553277&req=5

Figure 4: These graphs show kinematics of the knee joint during gait. (A) While the knee joint was flexed approximately 15° during the loading response, the tibia was externally rotated around the femur about 6° (green line and black arrow). (B) This amount of tibial rotation was maintained during the mid-stance phase (green line and black arrow). (C) As the knee reached full extension in the late-swing phase, the tibia was then rotated externally by 17°; thus, it almost reached the neutral position (green line and black arrow). Rz: rotational degrees in the sagittal plane, negative value is the extension angle and positive value is the flexion angle, Rx: rotational degrees in the coronal plane, negative value is the extension angle and positive value is the flexion angle, negative value is the valgus angle and positive value is the varus angle, Ry: rotational degrees in the transverse plane, negative value is the external rotation angle and positive value is the internal rotation angle.

Mentions: While the knee joint was being flexed approximately 15° during the loading response, the tibia was externally rotated around the femur. We authors first designated it as the 'paradoxical screw-home movement.' The measured angle was approximately 6° (Fig. 4A) using the SKB program. This amount of tibial rotation was maintained during the mid-stance phase (Fig. 4B). As rapid flexion of the knee joint occurred in the pre-swing phase, the tibia started to rotate internally around the femur (a reversal of the screw-home movement). Internal rotation was maintained until it reached peak knee flexion in the initial swing phase. As the knee reached full extension in the lateswing phase, the tibia was rotated externally by 17° (Fig. 4C); thus, it almost reached the neutral position (screw-home movement).


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)

These graphs show kinematics of the knee joint during gait. (A) While the knee joint was flexed approximately 15° during the loading response, the tibia was externally rotated around the femur about 6° (green line and black arrow). (B) This amount of tibial rotation was maintained during the mid-stance phase (green line and black arrow). (C) As the knee reached full extension in the late-swing phase, the tibia was then rotated externally by 17°; thus, it almost reached the neutral position (green line and black arrow). Rz: rotational degrees in the sagittal plane, negative value is the extension angle and positive value is the flexion angle, Rx: rotational degrees in the coronal plane, negative value is the extension angle and positive value is the flexion angle, negative value is the valgus angle and positive value is the varus angle, Ry: rotational degrees in the transverse plane, negative value is the external rotation angle and positive value is the internal rotation angle.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: These graphs show kinematics of the knee joint during gait. (A) While the knee joint was flexed approximately 15° during the loading response, the tibia was externally rotated around the femur about 6° (green line and black arrow). (B) This amount of tibial rotation was maintained during the mid-stance phase (green line and black arrow). (C) As the knee reached full extension in the late-swing phase, the tibia was then rotated externally by 17°; thus, it almost reached the neutral position (green line and black arrow). Rz: rotational degrees in the sagittal plane, negative value is the extension angle and positive value is the flexion angle, Rx: rotational degrees in the coronal plane, negative value is the extension angle and positive value is the flexion angle, negative value is the valgus angle and positive value is the varus angle, Ry: rotational degrees in the transverse plane, negative value is the external rotation angle and positive value is the internal rotation angle.
Mentions: While the knee joint was being flexed approximately 15° during the loading response, the tibia was externally rotated around the femur. We authors first designated it as the 'paradoxical screw-home movement.' The measured angle was approximately 6° (Fig. 4A) using the SKB program. This amount of tibial rotation was maintained during the mid-stance phase (Fig. 4B). As rapid flexion of the knee joint occurred in the pre-swing phase, the tibia started to rotate internally around the femur (a reversal of the screw-home movement). Internal rotation was maintained until it reached peak knee flexion in the initial swing phase. As the knee reached full extension in the lateswing phase, the tibia was rotated externally by 17° (Fig. 4C); thus, it almost reached the neutral position (screw-home movement).

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