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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2012

01.03.2012 | Knee

Knee functional flexion axis in osteoarthritic patients: comparison in vivo with transepicondylar axis using a navigation system

verfasst von: F. Colle, S. Bignozzi, N. Lopomo, S. Zaffagnini, L. Sun, M. Marcacci

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 3/2012

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Abstract

Purpose

No study, up to now, has examined the effect of arthritis on pathologic subjects using functional flexion axis (FFA). The purpose of this study is to understand whether arthritis affects somehow the FFA evaluation and to assess whether the FFA could be considered a usable reference for implant positioning for osteoarthritic knees.

Methods

Using a navigation system, FFA orientation was evaluated intraoperatively (computed with the mean helical axis method) in three different ranges of motion (0°–120°; 35°–80°; 35°–120°) and in two different planes (coronal and axial), for 111 osteoarthritis patients undergoing total knee arthroplasty. The results were compared with a control group of 60 patients that underwent ACL reconstruction. The angle between the transepicondylar axis (TEA) and FFA was computed.

Results

Results showed in arthritic knees on frontal plane, an average difference between TEA and FFA of −2.8° ± 5.0° while on axial plane it was 0.6° ± 4.7°. No statistical difference was found between the three ranges in axial view, whereas some difference was found in frontal view (P < 0.0001). The TEA–FFA angle was not correlated with limb alignment on axial plane, while it was, even if poor, in frontal plane. In the control group, in frontal and in axial view, no statistical difference was found for the angle between TEA and FFA.

Conclusions

FFA can be used as reference for implant positioning in axial plane also in pathologic knees, while for the frontal plane further investigations are required.
Literatur
1.
Zurück zum Zitat Aglietti P, Sensi L, Cuomo P, Ciardullo A (2008) Rotational position of femoral and tibial components in TKA using the femoral transepicondylar axis. Clin Orthop Relat Res 466:2751–2755PubMedCrossRef Aglietti P, Sensi L, Cuomo P, Ciardullo A (2008) Rotational position of femoral and tibial components in TKA using the femoral transepicondylar axis. Clin Orthop Relat Res 466:2751–2755PubMedCrossRef
2.
Zurück zum Zitat Asano T, Akagi M, Nakamura T (2005) The functional flexion-extension axis of the knee corresponds to the surgical epicondylar axis: in vivo analysis using a biplanar image-matching technique. J Arthroplast 20:1060–1067CrossRef Asano T, Akagi M, Nakamura T (2005) The functional flexion-extension axis of the knee corresponds to the surgical epicondylar axis: in vivo analysis using a biplanar image-matching technique. J Arthroplast 20:1060–1067CrossRef
3.
Zurück zum Zitat Asay JL, Mündermann A, Andriacchi TP (2009) Adaptive patterns of movement during stair climbing in patients with knee osteoarthritis. J Orthop Res 27:325–329PubMedCrossRef Asay JL, Mündermann A, Andriacchi TP (2009) Adaptive patterns of movement during stair climbing in patients with knee osteoarthritis. J Orthop Res 27:325–329PubMedCrossRef
4.
Zurück zum Zitat Besier TF, Sturnieks DL, Alderson JA, Lloyd DG (2003) Repeatability of gait data using a functional hip joint centre and a mean helical knee axis. J Biomech 36:1159–1168PubMedCrossRef Besier TF, Sturnieks DL, Alderson JA, Lloyd DG (2003) Repeatability of gait data using a functional hip joint centre and a mean helical knee axis. J Biomech 36:1159–1168PubMedCrossRef
5.
Zurück zum Zitat Blaha JD, Mancinelli CA, Simons WH, Kish VL, Thyagarajan G (2003) Kinematics of the human knee using an open chain cadaver model. Clin Orthop Relat Res 410:25–34PubMedCrossRef Blaha JD, Mancinelli CA, Simons WH, Kish VL, Thyagarajan G (2003) Kinematics of the human knee using an open chain cadaver model. Clin Orthop Relat Res 410:25–34PubMedCrossRef
6.
Zurück zum Zitat Blankevoort L, Huiskes R, de Lange A (1990) Helical axes of passive knee joint motions. J Biomech 23:1219–1229PubMedCrossRef Blankevoort L, Huiskes R, de Lange A (1990) Helical axes of passive knee joint motions. J Biomech 23:1219–1229PubMedCrossRef
7.
Zurück zum Zitat Casino D, Zaffagnini S, Martelli S, Lopomo N, Bignozzi S, Iacono F, Russo A, Marcacci M (2009) Intraoperative evaluation of total knee replacement: kinematic assessment with a navigation system. Knee Surg Sports Traumatol Arthrosc 17:369–373PubMedCrossRef Casino D, Zaffagnini S, Martelli S, Lopomo N, Bignozzi S, Iacono F, Russo A, Marcacci M (2009) Intraoperative evaluation of total knee replacement: kinematic assessment with a navigation system. Knee Surg Sports Traumatol Arthrosc 17:369–373PubMedCrossRef
8.
Zurück zum Zitat Churchill DL, Incavo SJ, Johnson CC, Beynnon BD (1998) The transepicondylar axis approximates the optimal flexion axis of the knee. Clin Orthop Relat Res 356:111–118PubMedCrossRef Churchill DL, Incavo SJ, Johnson CC, Beynnon BD (1998) The transepicondylar axis approximates the optimal flexion axis of the knee. Clin Orthop Relat Res 356:111–118PubMedCrossRef
9.
Zurück zum Zitat Cole GK, Nigg BM, Ronsky JL, Yeadon MR (1993) Application of the joint coordinate system to three-dimensional joint attitude and movement representation: a standardization proposal. J Biomech Eng 115:344–349PubMedCrossRef Cole GK, Nigg BM, Ronsky JL, Yeadon MR (1993) Application of the joint coordinate system to three-dimensional joint attitude and movement representation: a standardization proposal. J Biomech Eng 115:344–349PubMedCrossRef
10.
Zurück zum Zitat Dennis DA, Mahfouz MR, Komistek RD, Hoff W (2005) In vivo determination of normal and anterior cruciate ligament-deficient knee kinematics. J Biomech 38:241–253PubMedCrossRef Dennis DA, Mahfouz MR, Komistek RD, Hoff W (2005) In vivo determination of normal and anterior cruciate ligament-deficient knee kinematics. J Biomech 38:241–253PubMedCrossRef
11.
Zurück zum Zitat Eckhoff DG, Dwyer TF, Bach JM, Spitzer VM, Reinig KD (2001) Three-dimensional morphology of the distal part of the femur viewed in virtual reality. J Bone Joint Surg Am 83-A(Suppl 2):43–50 Eckhoff DG, Dwyer TF, Bach JM, Spitzer VM, Reinig KD (2001) Three-dimensional morphology of the distal part of the femur viewed in virtual reality. J Bone Joint Surg Am 83-A(Suppl 2):43–50
12.
Zurück zum Zitat Eckhoff D, Hogan C, DiMatteo L, Robinson M, Bach J (2007) Difference between the epicondylar and cylindrical axis of the knee. Clin Orthop Relat Res 461:238–244PubMed Eckhoff D, Hogan C, DiMatteo L, Robinson M, Bach J (2007) Difference between the epicondylar and cylindrical axis of the knee. Clin Orthop Relat Res 461:238–244PubMed
13.
Zurück zum Zitat Ehrig RM, Taylor WR, Duda GN, Heller MO (2007) A survey of formal methods for determining functional joint axes. J Biomech 40:2150–2157PubMedCrossRef Ehrig RM, Taylor WR, Duda GN, Heller MO (2007) A survey of formal methods for determining functional joint axes. J Biomech 40:2150–2157PubMedCrossRef
14.
Zurück zum Zitat Freeman MAR, Pinskerova V (2003) The movement of the knee studied by magnetic resonance imaging. Clin Orthop Relat Res 410:35–43PubMedCrossRef Freeman MAR, Pinskerova V (2003) The movement of the knee studied by magnetic resonance imaging. Clin Orthop Relat Res 410:35–43PubMedCrossRef
15.
Zurück zum Zitat Freeman MAR, Pinskerova V (2005) The movement of the normal tibio-femoral joint. J Biomech 38:197–208PubMedCrossRef Freeman MAR, Pinskerova V (2005) The movement of the normal tibio-femoral joint. J Biomech 38:197–208PubMedCrossRef
16.
Zurück zum Zitat Galaud B, Beaufils P, Michaut M, Abadie P, Fallet L, Boisrenoult P (2008) Distal femoral torsion: comparison of CT scan and intra operative navigation measurements during total knee arthroplasty. A report of 70 cases. Rev Chir Orthop Reparatrice Appar Mot 94:573–579PubMedCrossRef Galaud B, Beaufils P, Michaut M, Abadie P, Fallet L, Boisrenoult P (2008) Distal femoral torsion: comparison of CT scan and intra operative navigation measurements during total knee arthroplasty. A report of 70 cases. Rev Chir Orthop Reparatrice Appar Mot 94:573–579PubMedCrossRef
17.
Zurück zum Zitat Gamage SSHU, Lasenby J (2002) New least squares solutions for estimating the average centre of rotation and the axis of rotation. J Biomech 35:87–93PubMedCrossRef Gamage SSHU, Lasenby J (2002) New least squares solutions for estimating the average centre of rotation and the axis of rotation. J Biomech 35:87–93PubMedCrossRef
18.
Zurück zum Zitat Gao B, Zheng NN (2010) Alterations in three-dimensional joint kinematics of anterior cruciate ligament-deficient and -reconstructed knees during walking. Clin Biomech (Bristol, Avon) 25:222–229CrossRef Gao B, Zheng NN (2010) Alterations in three-dimensional joint kinematics of anterior cruciate ligament-deficient and -reconstructed knees during walking. Clin Biomech (Bristol, Avon) 25:222–229CrossRef
19.
Zurück zum Zitat Georgoulis AD, Papadonikolakis A, Papageorgiou CD, Mitsou A, Stergiou N (2003) Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking. Am J Sports Med 31:75–79PubMed Georgoulis AD, Papadonikolakis A, Papageorgiou CD, Mitsou A, Stergiou N (2003) Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking. Am J Sports Med 31:75–79PubMed
20.
Zurück zum Zitat Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105:136–144PubMedCrossRef Grood ES, Suntay WJ (1983) A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng 105:136–144PubMedCrossRef
21.
Zurück zum Zitat Jenny J, Boeri C (2004) Low reproducibility of the intra-operative measurement of the transepicondylar axis during total knee replacement. Acta Orthop Scand 75:74–77PubMedCrossRef Jenny J, Boeri C (2004) Low reproducibility of the intra-operative measurement of the transepicondylar axis during total knee replacement. Acta Orthop Scand 75:74–77PubMedCrossRef
22.
Zurück zum Zitat Kanisawa I, Banks AZ, Banks SA, Moriya H, Tsuchiya A (2003) Weight-bearing knee kinematics in subjects with two types of anterior cruciate ligament reconstructions. Knee Surg Sports Traumatol Arthrosc 11:16–22PubMed Kanisawa I, Banks AZ, Banks SA, Moriya H, Tsuchiya A (2003) Weight-bearing knee kinematics in subjects with two types of anterior cruciate ligament reconstructions. Knee Surg Sports Traumatol Arthrosc 11:16–22PubMed
23.
Zurück zum Zitat Kessler O, Dürselen L, Banks S, Mannel H, Marin F (2007) Sagittal curvature of total knee replacements predicts in vivo kinematics. Clin Biomech (Bristol, Avon) 22:52–58CrossRef Kessler O, Dürselen L, Banks S, Mannel H, Marin F (2007) Sagittal curvature of total knee replacements predicts in vivo kinematics. Clin Biomech (Bristol, Avon) 22:52–58CrossRef
24.
Zurück zum Zitat Kärrholm J, Jonsson H, Nilsson KG, Söderqvist I (1994) Kinematics of successful knee prostheses during weight-bearing: three-dimensional movements and positions of screw axes in the Tricon-M and Miller-Galante designs. Knee Surg Sports Traumatol Arthrosc 2:50–59PubMedCrossRef Kärrholm J, Jonsson H, Nilsson KG, Söderqvist I (1994) Kinematics of successful knee prostheses during weight-bearing: three-dimensional movements and positions of screw axes in the Tricon-M and Miller-Galante designs. Knee Surg Sports Traumatol Arthrosc 2:50–59PubMedCrossRef
25.
Zurück zum Zitat Lee D, Park J, Song D, Padhy D, Jeong W, Han S (2010) Accuracy of soft tissue balancing in TKA: comparison between navigation-assisted gap balancing and conventional measured resection. Knee Surg Sports Traumatol Arthrosc 18:381–387PubMedCrossRef Lee D, Park J, Song D, Padhy D, Jeong W, Han S (2010) Accuracy of soft tissue balancing in TKA: comparison between navigation-assisted gap balancing and conventional measured resection. Knee Surg Sports Traumatol Arthrosc 18:381–387PubMedCrossRef
26.
Zurück zum Zitat Mannel H, Marin F, Claes L, Dürselen L (2004) Anterior cruciate ligament rupture translates the axes of motion within the knee. Clin Biomech (Bristol, Avon) 19:130–135CrossRef Mannel H, Marin F, Claes L, Dürselen L (2004) Anterior cruciate ligament rupture translates the axes of motion within the knee. Clin Biomech (Bristol, Avon) 19:130–135CrossRef
27.
Zurück zum Zitat Mannel H, Marin F, Claes L, Dürselen L (2004) Establishment of a knee-joint coordinate system from helical axes analysis—a kinematic approach without anatomical referencing. IEEE Trans Biomed Eng 51:1341–1347PubMedCrossRef Mannel H, Marin F, Claes L, Dürselen L (2004) Establishment of a knee-joint coordinate system from helical axes analysis—a kinematic approach without anatomical referencing. IEEE Trans Biomed Eng 51:1341–1347PubMedCrossRef
28.
Zurück zum Zitat Marcacci M, Molgora AP, Zaffagnini S, Vascellari A, Iacono F, Presti ML (2003) Anatomic double-bundle anterior cruciate ligament reconstruction with hamstrings. Arthroscopy 19:540–546PubMedCrossRef Marcacci M, Molgora AP, Zaffagnini S, Vascellari A, Iacono F, Presti ML (2003) Anatomic double-bundle anterior cruciate ligament reconstruction with hamstrings. Arthroscopy 19:540–546PubMedCrossRef
29.
Zurück zum Zitat Marin F, Sangeux M, Charleux F, Ho Ba Tho M, Dürselen L (2006) Can a finite set of knee extension in supine position be used for a knee functional examination? J Biomech 39:359–363PubMedCrossRef Marin F, Sangeux M, Charleux F, Ho Ba Tho M, Dürselen L (2006) Can a finite set of knee extension in supine position be used for a knee functional examination? J Biomech 39:359–363PubMedCrossRef
30.
Zurück zum Zitat Martelli S, Lopomo N, Greggio S, Ferretti E, Visani A (2006) Development and applications of a software tool for diarthrodial joint analysis. Comput Methods Programs Biomed 83:50–56PubMedCrossRef Martelli S, Lopomo N, Greggio S, Ferretti E, Visani A (2006) Development and applications of a software tool for diarthrodial joint analysis. Comput Methods Programs Biomed 83:50–56PubMedCrossRef
31.
Zurück zum Zitat Martelli S, Zaffagnini S, Bignozzi S, Bontempi M, Marcacci M (2006) Validation of a new protocol for computer-assisted evaluation of kinematics of double-bundle ACL reconstruction. Clin Biomech 21:279–287CrossRef Martelli S, Zaffagnini S, Bignozzi S, Bontempi M, Marcacci M (2006) Validation of a new protocol for computer-assisted evaluation of kinematics of double-bundle ACL reconstruction. Clin Biomech 21:279–287CrossRef
32.
Zurück zum Zitat Martelli S, Zaffagnini S, Bignozzi S, Lopomo NF, Iacono F, Marcacci M (2007) Kin-nav navigation system for kinematic assessment in anterior cruciate ligament reconstruction: features, use, and perspectives. Proc Inst Mech Eng [H] 221:725–737 Martelli S, Zaffagnini S, Bignozzi S, Lopomo NF, Iacono F, Marcacci M (2007) Kin-nav navigation system for kinematic assessment in anterior cruciate ligament reconstruction: features, use, and perspectives. Proc Inst Mech Eng [H] 221:725–737
33.
Zurück zum Zitat Martelli S, Lopomo N, Bignozzi S, Zaffagnini S, Visani A (2007) Validation of a new protocol for navigated intraoperative assessment of knee kinematics. Comput Biol Med 37:872–878PubMedCrossRef Martelli S, Lopomo N, Bignozzi S, Zaffagnini S, Visani A (2007) Validation of a new protocol for navigated intraoperative assessment of knee kinematics. Comput Biol Med 37:872–878PubMedCrossRef
34.
Zurück zum Zitat Michaut M, Beaufils P, Galaud B, Abadie P, Boisrenoult P, Fallet L (2008) Rotational alignment of femoral component with computed-assisted surgery (CAS) during total knee arthroplasty. Rev Chir Orthop Reparatrice Appar Mot 94:580–584PubMedCrossRef Michaut M, Beaufils P, Galaud B, Abadie P, Boisrenoult P, Fallet L (2008) Rotational alignment of femoral component with computed-assisted surgery (CAS) during total knee arthroplasty. Rev Chir Orthop Reparatrice Appar Mot 94:580–584PubMedCrossRef
35.
Zurück zum Zitat Mihalko WM, Ali M, Phillips MJ, Bayers-Thering M, Krackow KA (2008) Passive knee kinematics before and after total knee arthroplasty: are we correcting pathologic motion? J Arthroplast 23:57–60CrossRef Mihalko WM, Ali M, Phillips MJ, Bayers-Thering M, Krackow KA (2008) Passive knee kinematics before and after total knee arthroplasty: are we correcting pathologic motion? J Arthroplast 23:57–60CrossRef
36.
Zurück zum Zitat Miura K, Ishibashi Y, Tsuda E, Fukuda A, Tsukada H, Toh S (2010) Intraoperative comparison of knee laxity between anterior cruciate ligament-reconstructed knee and contralateral stable knee using navigation system. Arthroscopy 26:1203–1211PubMedCrossRef Miura K, Ishibashi Y, Tsuda E, Fukuda A, Tsukada H, Toh S (2010) Intraoperative comparison of knee laxity between anterior cruciate ligament-reconstructed knee and contralateral stable knee using navigation system. Arthroscopy 26:1203–1211PubMedCrossRef
37.
Zurück zum Zitat Morizane K, Takahashi T, Konishi F, Yamamoto H (2011) The anterior trochlear line as a reference for femoral component positioning in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc: PMID: 21290108 Morizane K, Takahashi T, Konishi F, Yamamoto H (2011) The anterior trochlear line as a reference for femoral component positioning in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc: PMID: 21290108
38.
Zurück zum Zitat Most E, Axe J, Rubash H, Li G (2004) Sensitivity of the knee joint kinematics calculation to selection of flexion axes. J Biomech 37:1743–1748PubMedCrossRef Most E, Axe J, Rubash H, Li G (2004) Sensitivity of the knee joint kinematics calculation to selection of flexion axes. J Biomech 37:1743–1748PubMedCrossRef
39.
Zurück zum Zitat Papannagari R, Gill TJ, Defrate LE, Moses JM, Petruska AJ, Li G (2006) In vivo kinematics of the knee after anterior cruciate ligament reconstruction: a clinical and functional evaluation. Am J Sports Med 34:2006–2012PubMedCrossRef Papannagari R, Gill TJ, Defrate LE, Moses JM, Petruska AJ, Li G (2006) In vivo kinematics of the knee after anterior cruciate ligament reconstruction: a clinical and functional evaluation. Am J Sports Med 34:2006–2012PubMedCrossRef
40.
Zurück zum Zitat Pinskerova V, Maquet P, Freeman MA (2000) Writings on the knee between 1836 and 1917. J Bone Joint Surg Br 82:1100–1102PubMedCrossRef Pinskerova V, Maquet P, Freeman MA (2000) Writings on the knee between 1836 and 1917. J Bone Joint Surg Br 82:1100–1102PubMedCrossRef
41.
Zurück zum Zitat Sheehan FT (2007) The finite helical axis of the knee joint (a non-invasive in vivo study using fast-PC MRI). J Biomech 40:1038–1047PubMedCrossRef Sheehan FT (2007) The finite helical axis of the knee joint (a non-invasive in vivo study using fast-PC MRI). J Biomech 40:1038–1047PubMedCrossRef
42.
Zurück zum Zitat Siston RA, Patel JJ, Goodman SB, Delp SL, Giori NJ (2005) The variability of femoral rotational alignment in total knee arthroplasty. J Bone Joint Surg Am 87:2276–2280PubMedCrossRef Siston RA, Patel JJ, Goodman SB, Delp SL, Giori NJ (2005) The variability of femoral rotational alignment in total knee arthroplasty. J Bone Joint Surg Am 87:2276–2280PubMedCrossRef
43.
Zurück zum Zitat Siston RA, Cromie MJ, Gold GE, Goodman SB, Delp SL, Maloney WJ, Giori NJ (2008) Averaging different alignment axes improves femoral rotational alignment in computer-navigated total knee arthroplasty. J Bone Joint Surg Am 90:2098–2104PubMedCrossRef Siston RA, Cromie MJ, Gold GE, Goodman SB, Delp SL, Maloney WJ, Giori NJ (2008) Averaging different alignment axes improves femoral rotational alignment in computer-navigated total knee arthroplasty. J Bone Joint Surg Am 90:2098–2104PubMedCrossRef
44.
Zurück zum Zitat Soudan K, Van Audekercke R, Martens M (1979) Methods, difficulties and inaccuracies in the study of human joint kinematics and pathokinematics by the instant axis concept. Example: the knee joint. J Biomech 12:27–33PubMedCrossRef Soudan K, Van Audekercke R, Martens M (1979) Methods, difficulties and inaccuracies in the study of human joint kinematics and pathokinematics by the instant axis concept. Example: the knee joint. J Biomech 12:27–33PubMedCrossRef
45.
Zurück zum Zitat Stiehl JB, Abbott BD (1995) Morphology of the transepicondylar axis and its application in primary and revision total knee arthroplasty. J Arthroplast 10:785–789CrossRef Stiehl JB, Abbott BD (1995) Morphology of the transepicondylar axis and its application in primary and revision total knee arthroplasty. J Arthroplast 10:785–789CrossRef
46.
Zurück zum Zitat Tashman S, Collon D, Anderson K, Kolowich P, Anderst W (2004) Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med 32:975–983PubMedCrossRef Tashman S, Collon D, Anderson K, Kolowich P, Anderst W (2004) Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med 32:975–983PubMedCrossRef
47.
Zurück zum Zitat Walker PS, Heller Y, Yildirim G, Immerman I (2010) Reference axes for comparing the motion of knee replacements with the anatomic knee. Knee: PMID: 20719517 Walker PS, Heller Y, Yildirim G, Immerman I (2010) Reference axes for comparing the motion of knee replacements with the anatomic knee. Knee: PMID: 20719517
48.
Zurück zum Zitat Wilson DR, Feikes JD, Zavatsky AB, O’Connor JJ (2000) The components of passive knee movement are coupled to flexion angle. J Biomech 33:465–473PubMedCrossRef Wilson DR, Feikes JD, Zavatsky AB, O’Connor JJ (2000) The components of passive knee movement are coupled to flexion angle. J Biomech 33:465–473PubMedCrossRef
49.
Zurück zum Zitat Wolf A, Degani A (2007) Recognizing knee pathologies by classifying instantaneous screws of the six degrees-of-freedom knee motion. Med Biol Eng Comput 45:475–482PubMedCrossRef Wolf A, Degani A (2007) Recognizing knee pathologies by classifying instantaneous screws of the six degrees-of-freedom knee motion. Med Biol Eng Comput 45:475–482PubMedCrossRef
50.
Zurück zum Zitat Woltring HJ, Huiskes R, de Lange A, Veldpaus FE (1985) Finite centroid and helical axis estimation from noisy landmark measurements in the study of human joint kinematics. J Biomech 18:379–389PubMedCrossRef Woltring HJ, Huiskes R, de Lange A, Veldpaus FE (1985) Finite centroid and helical axis estimation from noisy landmark measurements in the study of human joint kinematics. J Biomech 18:379–389PubMedCrossRef
51.
Zurück zum Zitat Woltring HJ (1994) 3-D attitude representation of human joints: a standardization proposal. J Biomech 27:1399–1414PubMedCrossRef Woltring HJ (1994) 3-D attitude representation of human joints: a standardization proposal. J Biomech 27:1399–1414PubMedCrossRef
52.
Zurück zum Zitat van den Bogert AJ, Reinschmidt C, Lundberg A (2008) Helical axes of skeletal knee joint motion during running. J Biomech 41:1632–1638PubMedCrossRef van den Bogert AJ, Reinschmidt C, Lundberg A (2008) Helical axes of skeletal knee joint motion during running. J Biomech 41:1632–1638PubMedCrossRef
Metadaten
Titel
Knee functional flexion axis in osteoarthritic patients: comparison in vivo with transepicondylar axis using a navigation system
verfasst von
F. Colle
S. Bignozzi
N. Lopomo
S. Zaffagnini
L. Sun
M. Marcacci
Publikationsdatum
01.03.2012
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 3/2012
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1604-z

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