Short communicationCan a finite set of knee extension in supine position be used for a knee functional examination?
Introduction
The use of the magnetic resonance imaging (MRI) has increased for non-invasive in vivo studies of the knee joint (Lerner et al., 2003). MRI is primarily used to obtain anatomic and geometric information. However, developments in MRI technology permit using MRI for functional examination of the knee (Shellock et al., 1991).
A functional examination of the knee consists of analysing the kinematics of the joint in order to detect impaired joint mechanisms (Nakanishi et al., 1997). As the main functions of anatomical knee structures are to stabilize and to move the knee joint under weight-bearing condition (Watkins, 1999), most of the knee functional examination are performed under weight-bearing conditions (Andriacchi et al., 2003). The squat exercise is often used to quantify the knee function or regain function in rehabilitation programs (Escamilla, 2001; Beynnon et al., 2002).
However, due to technical limitations (e.g. MRI signal calculation), a functional examination by MRI consists of a set of static joint positions (Muhle et al., 1996; Niitsu, 2001). Moreover, to obtain high-quality images with a short-time acquisition, a closed MRI unit with high magnetic field (1.5 T) is used (Maubon et al., 1999), requiring the acquisition to be made in a supine position. It has been assumed that a set of static positions in the supine position can be used to represent the function of the knee joint (Muhle et al., 1996; Niitsu, 2001).
The aim of this study is to determine if a finite set of knee extension in a supine position is representative of the load-bearing knee function (e.g. knee squat) by quantifying the kinematic difference between:
- (1)
a knee extension in supine position from continuous motion and from a finite set of static positions (finite vs. continous),
- (2)
a knee extension in supine position and the ascent phase of a squat exercise (continuous unloaded vs. continuous loaded).
Section snippets
Material and method
Twenty healthy subjects (7 females, 13 males, average 30.6 years old, range 24–54 year) without ligament laxity or disorders were selected. All subjects were examined by an experienced surgeon of the Saint Côme hospital. The subjects performed three knee extension exercises: a parallel squat and two knee extensions in supine position. In supine position, the knee extension was guided with the help of a drive device (Fig. 1). The drive device is a modification of that presented by Scarvell et
Results
The results presented large inter-individual variations (Fig. 2). Eight subjects had an average angle deviation and distance difference smaller than 5° and 5 mm, respectively, indicating a good correlation between the kinematics of the finite set of static positions and the continuous motion in supine position. Eight subjects had smaller than 5° or less than 5 mm. Finally, 4 subjects had larger than 5° and larger than 5 mm. For these subjects, kinematics of the two exercises were
Discussion and conclusion
Our study is based on the comparison of the motion using the screw motion theory by calculating of the finite helical axis (FHA). In the beginning of the 19th century, Chasles proved that any rigid body displacement can be realized by a rotation about an axis combined with a translation along this axis (Charles, 1880). In the particular case of the knee joint analysis the translation is negligible (Blankevoort et al., 1990). The complete description of the knee motion is the localization in
Acknowledgements
This work is supported by the Procope Program, German-French exchange program (French ministry of foreign affairs—German Academic Exchange Service).
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