Da. Dennis et al., IN-VIVO KNEE KINEMATICS DERIVED USING AN INVERSE PERSPECTIVE TECHNIQUE, Clinical orthopaedics and related research, (331), 1996, pp. 107-117
Sixty-four subjects having implanted and nonimplanted knees were studi
ed using fluoroscopic videos, Each subject, flexing in the sagittal pl
ane, performed successive deep knee bends under fluoroscopic surveilla
nce, Femorotibial contact in the sagittal plane was then determined us
ing image matching and discrete digitization. At full extension, the m
ean contact point of the normal and posterior stabilized implanted fem
urs was anterior to the tibial midpoint in the sagittal plane, The ave
rage position was 6.49 mm (+3 - +13 mm) for the normal knees and 0.30
mm (0- +4 mm) for the posterior stabilized knees, The implanted poster
ior cruciate retaining and anterior cruciate ligament deficient knees
differed from the other knee types. Their average initial contact was
posterior, The average contact at full extension for the posterior cru
ciate retaining and anterior cruciate ligament deficient knees was 5.1
3 mm (-2 - -8 mm) and -5.45 mm (-2 - -14 mm), respectively, The femur
of the normal knee contacts the tibia anterior to the midpoint in the
sagittal plane in full extension and translates posteriorly during fle
xion, The femur of the posterior stabilized knee contacts the tibia an
teriorly, slightly less than the normal knee, and rolls back posterior
ly during flexion similar to normal knees, The femurs of the posterior
cruciate retaining and anterior cruciate ligament deficient knees con
tact the tibia posterior in extension, but translate anteriorly during
midflexion in a substantial number of cases, which is kinematically o
pposite of the normal knees. The abnormal anterior femoral translation
observed in the posterior cruciate retaining knees may be a factor in
the premature polyethylene wear seen in retrieval studies.