Non-invasive quantification of knee kinematics: a cadaver study

Russell, David F. (2015) Non-invasive quantification of knee kinematics: a cadaver study. MD thesis, University of Glasgow.

Abstract

The ability to quantify kinematic parameters of the knee is crucial in understanding normal
biomechanics, recognising the presence of pathology and its severity, planning treatment
and evaluation of outcomes. Current methods of quantifying lower limb kinematics
remain limited in allowing accurate dynamic assessment. Computer assisted surgery
systems have been validated in quantifying kinematic parameters, but remain limited to the
operative setting. Recently, image-free computer assisted surgery technology has been
adapted for non-invasive use and validated in terms of repeatability in measuring coronal
and sagittal femorotibial mechanical alignment in extension. The aim of this thesis was to
develop and implement a set of validation protocols to quantify the reliability, precision
and accuracy of this non-invasive technology in quantifying lower limb coronal and
sagittal femorotibial mechanical alignment, anteroposterior and rotatory laxity of the knee
by comparison with a validated, commercially available image-free computer assisted
surgery system.
Pilot study confirmed feasibility of further experimental work and revealed that the noninvasive
method measured with satisfactory precision and accuracy: coronal mechanical
femorotibial alignment (MFTA) from extension to 30° knee flexion, anteroposterior
translation in extension and tibial rotatory laxity during flexion.
Further experiments using 12 fresh cadaveric limbs revealed that the non-invasive method
gave satisfactory precision and agreement with the invasive system measuring MFTA
without stress from extension to 40° knee flexion, and with 15Nm coronal stress from
extension to 30° knee flexion. Using 100N of anterior force on the tibia, the non-invasive
system was acceptably precise and accurate in measuring sagittal tibial displacement from
extension to 40° flexion. End of range apprehension, such as has been proven repeatable in
measuring tibial rotatory laxity was used and the non-invasive method gave superior
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precision and accuracy to most reported non-invasive devices in quantifying tibial rotatory
range of motion.
Non-invasive optical tracking systems provide a means to quantify important kinematic
parameters in health and disease, and could allow standardisation of knee examination
increasing communicability and translation of findings from the out-patient to operative
setting. This technology therefore could allow restoration of individual specific kinematics
in knee arthroplasty and soft-tissue reconstruction.

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Additional Information: Clinical Supervisor: Professor F. Picard Bioengineering Unit, University of Strathclyde Consultant Orthopaedic Surgeon Golden Jubilee National Hospital Agamemnon St. Clydebank Glasgow Scotland Email: Fred Picard [e-mail]
• Keywords: Kinematics, Knee, Orthopaedic surgery, total knee replacement, anterior cruciate ligament reconstruction, collateral ligament reconstruction, tibial rotation, cadaveric, non-invasive, image-free computer assisted orthopaedic surgery, navigated surgery
• Subjects: Q Science > QM Human anatomy; R Medicine > RD Surgery; R Medicine > RZ Other systems of medicine
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Supervisor's Name: Fogg, Dr Quentin
• Date of Award: 2015
• Depositing User: Dr David F. Russell
• Unique ID: glathesis:2015-6300
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 13 May 2015 14:26
• Last Modified: 27 May 2015 15:10
• URI: https://theses.gla.ac.uk/id/eprint/6300