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Gianluca Gatti

This article presents the validation of a technique to assess the appropriateness of a 2 degree-of-freedom model for the human knee, and, in which case, the dominant axes of flexion/extension and internal/external longitudinal rotation are estimated. The technique relies on the use of an instrumented spatial linkage for the accurate detection of passive knee kinematics, and it is based on the assumption that points on the longitudinal rotation axis describe nearly circular and planar trajectories, whereas the flexion/extension axis is perpendicular to those trajectories through their centers of rotation. By manually enforcing a tibia rotation while bending the knee in flexion, a standard optimization algorithm is used to estimate the approximate axis of longitudinal rotation, and the axis of flexion is estimated consequently. The proposed technique is validated through simulated data and experimentally applied on a 2 degree-of-freedom mechanical joint. A procedure is proposed to verify the fixed axes assumption for the knee model. The suggested methodology could be possibly valuable in understanding knee kinematics, and in particular for the design and implant of customized hinged external fixators, which have shown to be effective in knee dislocation treatment and rehabilitation.

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Mina Samukawa, David Magee and Masaki Katayose

Context:

The effects of tibial rotation after ACL injury have not yet been well determined.

Objective:

To show whether clinical outcomes such as the amount of tibial rotation can affect functional outcomes in normal and ACL deficient knees.

Design:

Case control study.

Setting:

Research laboratory.

Participants:

Twenty normal subjects (Control) and 20 subjects with ACL deficient knees (ACL).

Main Outcome Measures:

Tibial rotation at 30 and 90 degrees of knee flexion was measured using an inclinometer. One-legged hop, crossover hop, figure-of-eight running and 10-m running tests were used and determined the effect(s) of tibial rotation on the outcome of the functional tests.

Results:

There were significant between-group differences in internal and external rotation. The relationship between external tibial rotation and the figure-of-eight index was significantly negatively correlated.

Conclusions:

The amount of tibial rotation is greater in ACL ruptured knees than in uninjured knees, and these greater amounts of tibial rotation affected the figure-of-eight running index.

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Ross H. Miller, Stacey A. Meardon, Timothy R. Derrick and Jason C. Gillette

Previous research has proposed that a lack of variability in lower extremity coupling during running is associated with pathology. The purpose of the study was to evaluate lower extremity coupling variability in runners with and without a history of iliotibial band syndrome (ITBS) during an exhaustive run. Sixteen runners ran to voluntary exhaustion on a motorized treadmill while a motion capture system recorded reflective marker locations. Eight runners had a history of ITBS. At the start and end of the run, continuous relative phase (CRP) angles and CRP variability between strides were calculated for key lower extremity kinematic couplings. The ITBS runners demonstrated less CRP variability than controls in several couplings between segments that have been associated with knee pain and ITBS symptoms, including tibia rotation–rearfoot motion and rearfoot motion–thigh ad/abduction, but more variability in knee flexion/extension–foot ad/abduction. The ITBS runners also demonstrated low variability at heel strike in coupling between rearfoot motion–tibia rotation. The results suggest that runners prone to ITBS use abnormal segmental coordination patterns, particular in couplings involving thigh ad/abduction and tibia internal/external rotation. Implications for variability in injury etiology are suggested.