Normal coronal kinematics of dynamic alignment and bony positions relative to the ground in three-dimensional motion analysis during gait: A preliminary study

Article type: Research Article

Authors: Tomiyama, Yasuyuki^{a; b} | Mochizuki, Tomoharu^a; | Tanifuji, Osamu^a | Nishino, Katsutoshi^c | Tanaka, Masaei^c | Omori, Go^d | Yamamoto, Noriaki^b | Koga, Hiroshi^e | Koga, Yoshio^f | Kawashima, Hiroyuki^a

Affiliations: [a] Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan | [b] Department of Orthopaedic Surgery, Niigata Rehabilitation Hospital, Niitaga, Japan | [c] Niigata Institute for Health and Sports Medicine, Niigata, Japan | [d] Department of Health and Sports, Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan | [e] Division of Musculoskeletal Science for Frailty, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan | [f] Department of Orthopaedic Surgery, Nioji Onsen Hospital, Niigata, Japan

Correspondence: [*] Corresponding author: Tomoharu Mochizuki, MD, PhD, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata 951-8510, Japan. Tel.: +81 25 227 2272; Fax: +81 25 227 0782; E-mail: tommochi121710@gmail.com

Abstract: BACKGROUND:During gait, healthy knee coronal kinematics of each bony axis and lower extremity alignment are important because they could be useful as reference data for several surgeries and provide clarification of the etiology of diseases around the knee in healthy participants; however, it remains unknown. OBJECTIVE:The objective of this study was to clarify the kinematics of lower extremity alignment and the bony axes relative to the ground during gait, focused on the coronal plane, in healthy individuals by applying our unique three-dimensional (3D) motion analysis. METHODS:The study included 21 healthy individuals, including 9 healthy females and 12 healthy males with an average age of 36 ± 17 years. Knee kinematics were calculated in a gait analysis by combining the data from a motion-capture system and a 3D lower-extremity alignment assessment system on biplanar long-leg radiographs by using a 3D-2D registration technique. The main kinematic parameters were the dynamic position change relative to the ground, applying the femoral anatomical axis (FAA), tibial anatomical axis (TAA), and dynamic alignment in the coronal plane during the stance phase of gait. RESULTS:The average changes in FAA, TAA, and dynamic varus alignment were 3.7° ± 1.2°, 3.5° ± 0.8°, and 3.0° ± 1.2°, respectively. The TAA tilted laterally during the loading response and a plateau area appeared afterwards; the FAA gradually inclined laterally until the terminal stance phase, and the dynamic alignment showed varus angular change during the loading response. CONCLUSIONS:The tibia and femur were found to change approximately 2–5° of the position of the bony axes relative to the ground. In terms of clinical relevance, our findings can be used to clarify the etiology of diseases around the knee joint and as reference data for surgeries.

Keywords: Normal knee kinematics, gait analysis, bony axis, dynamic alignment

DOI: 10.3233/BME-211383

Journal: Bio-Medical Materials and Engineering, vol. 34, no. 1, pp. 37-49, 2023