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Related Experiment Videos

Does the femur roll-back with flexion?

V Pinskerova1, P Johal, S Nakagawa

  • 1First Orthopaedic Clinic, Charles University, Prague, Czech Republic.

The Journal of Bone and Joint Surgery. British Volume
|August 28, 2004
PubMed
Summary

Knee flexion involves distinct movements of the femoral condyle and contact points. The lateral femoral condyle rolls back, but the medial does not, challenging the concept of uniform femoral roll-back during knee flexion.

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Area of Science:

  • Orthopedics
  • Biomechanics
  • Medical Imaging

Background:

  • Understanding knee joint kinematics is crucial for diagnosing and treating knee pathologies.
  • The concept of femoral roll-back during flexion is widely accepted but lacks detailed biomechanical validation.

Purpose of the Study:

  • To investigate and compare the in-vivo and in-vitro movements of the femoral condyle and the tibiofemoral contact point during knee flexion.
  • To clarify the kinematics of the medial and lateral compartments of the knee joint.

Main Methods:

  • MRI scans of the knee were acquired in cadavers and volunteers at various flexion angles (0-120 degrees).
  • Sagittal images were analyzed to identify the flexion facet center (FFC) of the femur and the contact point (CP) between femoral and tibial subchondral plates.

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  • The anteroposterior positions of FFC and CP were measured relative to the posterior tibial cortex.

    • Main Results:

    • Medial compartment: FFC and CP coincided from 30-120 degrees; CP moved anteriorly from 30-0 degrees while FFC remained stationary.
    • Lateral compartment: FFC and CP moved posteriorly together from 20-120 degrees; both moved anteriorly from 20 degrees to full extension, with CP moving more.
    • Differences in FFC and CP movements are attributable to the sagittal shapes of the femur and tibia.

    Conclusions:

    • The term 'femoral roll-back' is not uniformly applicable to the entire femur during flexion.
    • The lateral femoral condyle exhibits roll-back, while the medial condyle does not, indicating external femoral rotation around a medial center.
    • Tibiofemoral contact points move posteriorly but do not 'roll' in the same manner as the condyles.