A Moving Fluoroscope to Capture Tibiofemoral Kinematics During Complete Cycles of Free Level and Downhill Walking As Well As Stair Descent

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2017 Oct 11

PMID 29016647

Citations 22

Authors

Renate List

Barbara Postolka

Pascal Schutz

Marco Hitz

Peter Schwilch

Hans Gerber

Stephen J Ferguson

William R Taylor

Affiliations

Soon will be listed here.

Abstract

Videofluoroscopy has been shown to provide essential information in the evaluation of the functionality of total knee arthroplasties. However, due to the limitation in the field of view, most systems can only assess knee kinematics during highly restricted movements. To avoid the limitations of a static image intensifier, a moving fluoroscope has been presented as a standalone system that allows tracking of the knee during multiple complete cycles of level- and downhill-walking, as well as stair descent, in combination with the synchronous assessment of ground reaction forces and whole body skin marker measurements. Here, we assess the ability of the system to keep the knee in the field of view of the image intensifier. By measuring ten total knee arthroplasty subjects, we demonstrate that it is possible to maintain the knee to within 1.8 ± 1.4 cm vertically and 4.0 ± 2.6 cm horizontally of the centre of the intensifier throughout full cycles of activities of daily living. Since control of the system is based on real-time feedback of a wire sensor, the system is not dependent on repeatable gait patterns, but is rather able to capture pathological motion patterns with low inter-trial repeatability.

Citing Articles

Impact of the external knee flexion moment on patello-femoral loading derived from loads and kinematics.

Trepczynski A, Kneifel P, Heyland M, Leskovar M, Moewis P, Damm P Front Bioeng Biotechnol. 2025; 12:1473951.

PMID: 39881960 PMC: 11774905. DOI: 10.3389/fbioe.2024.1473951.

A reproducible representation of healthy tibiofemoral kinematics during stair descent using REFRAME - part I: REFRAME foundations and validation.

Ortigas-Vasquez A, Taylor W, Postolka B, Schutz P, Maas A, Woiczinski M Sci Rep. 2025; 15(1):2276.

PMID: 39824984 PMC: 11742382. DOI: 10.1038/s41598-025-86137-1.

In Vitro Verification of Simulated Daily Activities Using Implant-Specific Kinematics from In Vivo Measurements.

Behnam Y, Anantha Krishnan A, List R, Clary C Bioengineering (Basel). 2024; 11(11).

PMID: 39593768 PMC: 11591298. DOI: 10.3390/bioengineering11111108.

A reproducible representation of healthy tibiofemoral kinematics during stair descent using REFRAME - Part II: Exploring optimisation criteria and inter-subject differences.

Ortigas-Vasquez A, Taylor W, Postolka B, Schutz P, Maas A, Grupp T Sci Rep. 2024; 14(1):25345.

PMID: 39455805 PMC: 11511945. DOI: 10.1038/s41598-024-76275-3.

The role of limb alignment on natural tibiofemoral kinematics and kinetics.

Postolka B, Taylor W, Fucentese S, List R, Schutz P Bone Joint Res. 2024; 13(9):485-496.

PMID: 39266005 PMC: 11392572. DOI: 10.1302/2046-3758.139.BJR-2023-0162.R3.

References

Zhu Z, Li G . An automatic 2D-3D image matching method for reproducing spatial knee joint positions using single or dual fluoroscopic images. Comput Methods Biomech Biomed Engin. 2011; 15(11):1245-56. PMC: 3740401. DOI: 10.1080/10255842.2011.597387. View

Dennis A, Komistek R . An in vivo analysis of the effectiveness of the osteoarthritic knee brace during heel strike and midstance of gait. Acta Chir Orthop Traumatol Cech. 2010; 66(6):323-7. View

Lee S, Hidler J . Biomechanics of overground vs. treadmill walking in healthy individuals. J Appl Physiol (1985). 2007; 104(3):747-55. DOI: 10.1152/japplphysiol.01380.2006. View

Leardini A, Belvedere C, Astolfi L, Fantozzi S, Viceconti M, Taddei F . A new software tool for 3D motion analyses of the musculo-skeletal system. Clin Biomech (Bristol). 2006; 21(8):870-9. DOI: 10.1016/j.clinbiomech.2006.03.007. View

Hoff W, Komistek R, Dennis D, Gabriel S, Walker S . Three-dimensional determination of femoral-tibial contact positions under in vivo conditions using fluoroscopy. Clin Biomech (Bristol). 2001; 13(7):455-472. DOI: 10.1016/s0268-0033(98)00009-6. View

Andriacchi T, Galante J, Fermier R . The influence of total knee-replacement design on walking and stair-climbing. J Bone Joint Surg Am. 1982; 64(9):1328-35. View

Van de Velde S, Hosseini A, Kozanek M, Gill T, Rubash H, Li G . Application guidelines for dynamic knee joint analysis with a dual fluoroscopic imaging system. Acta Orthop Belg. 2010; 76(1):107-13. View

Moro-oka T, Muenchinger M, Canciani J, Banks S . Comparing in vivo kinematics of anterior cruciate-retaining and posterior cruciate-retaining total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2006; 15(1):93-9. DOI: 10.1007/s00167-006-0134-6. View

Wass E, Taylor N, Matsas A . Familiarisation to treadmill walking in unimpaired older people. Gait Posture. 2004; 21(1):72-9. DOI: 10.1016/j.gaitpost.2004.01.003. View

10.

Zhao D, Banks S, Mitchell K, DLima D, Colwell Jr C, Fregly B . Correlation between the knee adduction torque and medial contact force for a variety of gait patterns. J Orthop Res. 2007; 25(6):789-97. DOI: 10.1002/jor.20379. View

11.

Cappozzo A, Croce U, Leardini A, Chiari L . Human movement analysis using stereophotogrammetry. Part 1: theoretical background. Gait Posture. 2005; 21(2):186-96. DOI: 10.1016/j.gaitpost.2004.01.010. View

12.

Stolze H, Kuhtz-Buschbeck J, Mondwurf C, Boczek-Funcke A, Johnk K, Deuschl G . Gait analysis during treadmill and overground locomotion in children and adults. Electroencephalogr Clin Neurophysiol. 1998; 105(6):490-7. DOI: 10.1016/s0924-980x(97)00055-6. View

13.

Weese J, Penney G, Desmedt P, M Buzug T, Hill D, Hawkes D . Voxel-based 2-D/3-D registration of fluoroscopy images and CT scans for image-guided surgery. IEEE Trans Inf Technol Biomed. 2000; 1(4):284-93. DOI: 10.1109/4233.681173. View

14.

Burckhardt K, Szekely G, Notzli H, Hodler J, Gerber C . Submillimeter measurement of cup migration in clinical standard radiographs. IEEE Trans Med Imaging. 2005; 24(5):676-88. DOI: 10.1109/TMI.2005.846849. View

15.

Banks S, Hodge W . Accurate measurement of three-dimensional knee replacement kinematics using single-plane fluoroscopy. IEEE Trans Biomed Eng. 1996; 43(6):638-49. DOI: 10.1109/10.495283. View

16.

Li G, Wuerz T, DeFrate L . Feasibility of using orthogonal fluoroscopic images to measure in vivo joint kinematics. J Biomech Eng. 2004; 126(2):314-8. DOI: 10.1115/1.1691448. View

17.

Zuffi S, Leardini A, Catani F, Fantozzi S, Cappello A . A model-based method for the reconstruction of total knee replacement kinematics. IEEE Trans Med Imaging. 2000; 18(10):981-91. DOI: 10.1109/42.811310. View

18.

Lay A, Hass C, Gregor R . The effects of sloped surfaces on locomotion: a kinematic and kinetic analysis. J Biomech. 2005; 39(9):1621-8. DOI: 10.1016/j.jbiomech.2005.05.005. View

19.

Watt J, Franz J, Jackson K, Dicharry J, Riley P, Kerrigan D . A three-dimensional kinematic and kinetic comparison of overground and treadmill walking in healthy elderly subjects. Clin Biomech (Bristol). 2010; 25(5):444-9. DOI: 10.1016/j.clinbiomech.2009.09.002. View

20.

Warabi T, Kato M, Kiriyama K, Yoshida T, Kobayashi N . Treadmill walking and overground walking of human subjects compared by recording sole-floor reaction force. Neurosci Res. 2005; 53(3):343-8. DOI: 10.1016/j.neures.2005.08.005. View