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Tanaka T, Gale T, Nishida K, Xu C, Fu F, Anderst W. Posterior tibial slope and meniscal slope correlate with in vivo tibial internal rotation during running and drop jump. Knee Surg Sports Traumatol Arthrosc 2022; 31:2366-2373. [PMID: 36115904 DOI: 10.1007/s00167-022-07163-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The relationship between tibial bony and meniscus anatomy and knee kinematics during in vivo, high-impact activities remains unclear. This study aimed to determine if the posterior tibial slope (PTS) and meniscal slope (MS) are associated with in vivo anterior-posterior translation and internal tibia rotation during running and double-leg drop jumps in healthy knees. METHODS Nineteen collegiate athletes performed fast running at 5.0 m/s on an instrumented treadmill and double-leg drop jump from a 60 cm platform while biplane radiographs of the knee were acquired at 150 Hz. Tibiofemoral kinematics were determined using a validated model-based tracking process. Medial and lateral PTS and MS were measured using magnetic resonance imaging (MRI). RESULTS In fast running, more internal tibia rotation was associated with greater PTS (ρ = 0.336, P = 0.039) and MS (ρ = 0.405, P = 0.012) in the medial knee compartment. In the double-leg drop jump, more internal tibia rotation was associated with greater PTS (ρ = 0.431, P = 0.007) and MS (ρ = 0.323, P = 0.005) in the medial knee compartment, as well as a greater PTS in the lateral knee compartment (ρ = 0.445, P = 0.005). CONCLUSION These findings suggest that the medial and lateral PTS and medial MS are associated with the amount of knee rotation during high-impact activities. These in vivo findings improve our understanding of ACL injury risk by linking bone and meniscus morphology to dynamic kinematics.
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Affiliation(s)
- Toshikazu Tanaka
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.,Biodynamics Laboratory, University of Pittsburgh, Rivertech Building Complex, 3820 South Water Street, Pittsburgh, PA, 15203, USA
| | - Tom Gale
- Biodynamics Laboratory, University of Pittsburgh, Rivertech Building Complex, 3820 South Water Street, Pittsburgh, PA, 15203, USA
| | - Kyohei Nishida
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.,Biodynamics Laboratory, University of Pittsburgh, Rivertech Building Complex, 3820 South Water Street, Pittsburgh, PA, 15203, USA
| | - Caiqi Xu
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,Biodynamics Laboratory, University of Pittsburgh, Rivertech Building Complex, 3820 South Water Street, Pittsburgh, PA, 15203, USA.,Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Freddie Fu
- UPMC Freddie Fu Sports Medicine Center, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - William Anderst
- Biodynamics Laboratory, University of Pittsburgh, Rivertech Building Complex, 3820 South Water Street, Pittsburgh, PA, 15203, USA.
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Influence of Bone Morphology on In Vivo Tibio-Femoral Kinematics in Healthy Knees during Gait Activities. J Clin Med 2022; 11:jcm11175082. [PMID: 36079016 PMCID: PMC9457019 DOI: 10.3390/jcm11175082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 12/03/2022] Open
Abstract
An improved understanding of the relationships between bone morphology and in vivo tibio-femoral kinematics potentially enhances functional outcomes in patients with knee disorders. The aim of this study was to quantify the influence of femoral and tibial bony morphology on tibio-femoral kinematics throughout complete gait cycles in healthy subjects. Twenty-six volunteers underwent clinical examination, radiographic assessment, and dynamic video-fluoroscopy during level walking, downhill walking, and stair descent. Femoral computer-tomography (CT) measurements included medial condylar (MC) and lateral condylar (LC) width, MC and LC flexion circle, and lateral femoral condyle index (LFCI). Tibial CT measurements included both medial (MTP) and lateral tibial plateau (LTP) slopes, depths, lengths, and widths. The influence of bony morphology on tibial internal/external rotation and anteroposterior (AP)-translation of the lateral and medial compartments were analyzed in a multiple regression model. An increase in tibial internal/external rotation could be demonstrated with decreasing MC width β: −0.30 (95% CI: −0.58 to −0.03) (p = 0.03) during the loaded stance phase of level walking. An increased lateral AP-translation occurred with both a smaller LC flexion circle β: −0.16 (95% CI: −0.28 to −0.05) (p = 0.007) and a deeper MTP β: 0.90 (95% CI: 0.23 to 1.56) (p = 0.01) during the loaded stance phase of level walking. The identified relationship between in vivo tibio-femoral kinematics and bone morphology supports a customized approach and individual assessment of these factors in patients with knee disorders and potentially enhances functional outcomes in anterior cruciate ligament injuries and total knee arthroplasty.
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Munsch MA, LaBaze D, Pitcairn S, Piva SR, Anderst WJ. Differences between men and women in coupled subtalar and tibiofemoral joint kinematics during gait revealed through dynamic biplane radiography. J Biomech 2022; 141:111222. [PMID: 35878456 DOI: 10.1016/j.jbiomech.2022.111222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 11/19/2022]
Abstract
It has been suggested that subtalar and tibiofemoral kinematics are coupled, such that abnormal subtalar inversion during the impact and push-off portions of stance may affect tibial rotation, leading to abnormal compensatory knee motion. This study aimed to characterize tibiofemoral and subtalar coupled motion and to determine if sex-dependent differences exist in lower extremity coupled motion. Twenty young adults were imaged at 100 frames/s using dynamic biplane radiography while walking. Lower extremity CT scans were obtained and segmented into subject-specific 3D bone models. Digitally reconstructed radiographs generated from the models were matched to the biplane radiographs via a validated tracking process to obtain tibiofemoral and subtalar joint kinematics. Subtalar inversion/eversion was strongly associated with tibiofemoral internal/external rotation and tibiofemoral ab/adduction during impact and push-off (P < 0.001). Men reached neutral subtalar and tibiofemoral orientation at midstance, while women remained more inverted at the subtalar joint and more externally rotated at the tibiofemoral joint. The rate of tibiofemoral ab/adduction to subtalar eversion differed between sexes during push-off (P = 0.005). Women underwent subtalar inversion, as well as tibiofemoral internal rotation and adduction during push-off, while men underwent only subtalar inversion and tibiofemoral internal rotation, with effectively no tibiofemoral adduction. These results provide the first quantitative evidence characterizing subtalar and tibiofemoral coupled motion. Differences in coupled motion trajectories between men and women may be associated with the higher incidence of knee-related pathology in women. These novel findings may serve as a standard for comparison when evaluating patients with patellofemoral pain.
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Affiliation(s)
- Maria A Munsch
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Dukens LaBaze
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Samuel Pitcairn
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sara R Piva
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, United States
| | - William J Anderst
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, United States.
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