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Dynamic Knee Joint Line Orientation Is Not Predictive of Tibio-Femoral Load Distribution During Walking

Some approaches in total knee arthroplasty aim for an oblique joint line to achieve an even medio-lateral load distribution across the condyles during the stance phase of gait. While there is much focus on the angulation of the joint line in static frontal radiographs, precise knowledge of the assoc...

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Autores principales: Trepczynski, Adam, Moewis, Philippe, Damm, Philipp, Schütz, Pascal, Dymke, Jörn, Hommel, Hagen, Taylor, William R., Duda, Georg N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8607168/
https://www.ncbi.nlm.nih.gov/pubmed/34820363
http://dx.doi.org/10.3389/fbioe.2021.754715
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author Trepczynski, Adam
Moewis, Philippe
Damm, Philipp
Schütz, Pascal
Dymke, Jörn
Hommel, Hagen
Taylor, William R.
Duda, Georg N.
author_facet Trepczynski, Adam
Moewis, Philippe
Damm, Philipp
Schütz, Pascal
Dymke, Jörn
Hommel, Hagen
Taylor, William R.
Duda, Georg N.
author_sort Trepczynski, Adam
collection PubMed
description Some approaches in total knee arthroplasty aim for an oblique joint line to achieve an even medio-lateral load distribution across the condyles during the stance phase of gait. While there is much focus on the angulation of the joint line in static frontal radiographs, precise knowledge of the associated dynamic joint line orientation and the internal joint loading is limited. The aim of this study was to analyze how static alignment in frontal radiographs relates to dynamic alignment and load distribution, based on direct measurements of the internal joint loading and kinematics. A unique and novel combination of telemetrically measured in vivo knee joint loading and simultaneous internal joint kinematics derived from mobile fluoroscopy (“CAMS-Knee dataset”) was employed to access the dynamic alignment and internal joint loading in 6 TKA patients during level walking. Static alignment was measured in standard frontal postoperative radiographs while external adduction moments were computed based on ground reaction forces. Both static and dynamic parameters were analyzed to identify correlations using linear and non-linear regression. At peak loading during gait, the joint line was tilted laterally by 4°–7° compared to the static joint line in most patients. This dynamic joint line tilt did not show a strong correlation with the medial force (R (2): 0.17) or with the mediolateral force distribution (pseudo R (2): 0.19). However, the external adduction moment showed a strong correlation with the medial force (R (2): 0.85) and with the mediolateral force distribution (pseudo R (2): 0.78). Alignment measured in static radiographs has only limited predictive power for dynamic kinematics and loading, and even the dynamic orientation of the joint line is not an important factor for the medio-lateral knee load distribution. Preventive and rehabilitative measures should focus on the external knee adduction moment based on the vertical and horizontal components of the ground reaction forces.
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spelling pubmed-86071682021-11-23 Dynamic Knee Joint Line Orientation Is Not Predictive of Tibio-Femoral Load Distribution During Walking Trepczynski, Adam Moewis, Philippe Damm, Philipp Schütz, Pascal Dymke, Jörn Hommel, Hagen Taylor, William R. Duda, Georg N. Front Bioeng Biotechnol Bioengineering and Biotechnology Some approaches in total knee arthroplasty aim for an oblique joint line to achieve an even medio-lateral load distribution across the condyles during the stance phase of gait. While there is much focus on the angulation of the joint line in static frontal radiographs, precise knowledge of the associated dynamic joint line orientation and the internal joint loading is limited. The aim of this study was to analyze how static alignment in frontal radiographs relates to dynamic alignment and load distribution, based on direct measurements of the internal joint loading and kinematics. A unique and novel combination of telemetrically measured in vivo knee joint loading and simultaneous internal joint kinematics derived from mobile fluoroscopy (“CAMS-Knee dataset”) was employed to access the dynamic alignment and internal joint loading in 6 TKA patients during level walking. Static alignment was measured in standard frontal postoperative radiographs while external adduction moments were computed based on ground reaction forces. Both static and dynamic parameters were analyzed to identify correlations using linear and non-linear regression. At peak loading during gait, the joint line was tilted laterally by 4°–7° compared to the static joint line in most patients. This dynamic joint line tilt did not show a strong correlation with the medial force (R (2): 0.17) or with the mediolateral force distribution (pseudo R (2): 0.19). However, the external adduction moment showed a strong correlation with the medial force (R (2): 0.85) and with the mediolateral force distribution (pseudo R (2): 0.78). Alignment measured in static radiographs has only limited predictive power for dynamic kinematics and loading, and even the dynamic orientation of the joint line is not an important factor for the medio-lateral knee load distribution. Preventive and rehabilitative measures should focus on the external knee adduction moment based on the vertical and horizontal components of the ground reaction forces. Frontiers Media S.A. 2021-11-02 /pmc/articles/PMC8607168/ /pubmed/34820363 http://dx.doi.org/10.3389/fbioe.2021.754715 Text en Copyright © 2021 Trepczynski, Moewis, Damm, Schütz, Dymke, Hommel, Taylor and Duda. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Trepczynski, Adam
Moewis, Philippe
Damm, Philipp
Schütz, Pascal
Dymke, Jörn
Hommel, Hagen
Taylor, William R.
Duda, Georg N.
Dynamic Knee Joint Line Orientation Is Not Predictive of Tibio-Femoral Load Distribution During Walking
title Dynamic Knee Joint Line Orientation Is Not Predictive of Tibio-Femoral Load Distribution During Walking
title_full Dynamic Knee Joint Line Orientation Is Not Predictive of Tibio-Femoral Load Distribution During Walking
title_fullStr Dynamic Knee Joint Line Orientation Is Not Predictive of Tibio-Femoral Load Distribution During Walking
title_full_unstemmed Dynamic Knee Joint Line Orientation Is Not Predictive of Tibio-Femoral Load Distribution During Walking
title_short Dynamic Knee Joint Line Orientation Is Not Predictive of Tibio-Femoral Load Distribution During Walking
title_sort dynamic knee joint line orientation is not predictive of tibio-femoral load distribution during walking
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8607168/
https://www.ncbi.nlm.nih.gov/pubmed/34820363
http://dx.doi.org/10.3389/fbioe.2021.754715
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