Implementation of a five degree of freedom automated system to determine knee flexibility in vitro

This article describes an automated system designed to study the complete flexibility functions of the knee in vitro. The system allows five degrees of freedom with flexion angle being fixed, though adjustable from 0 to 45 deg. Loads corresponding to each of the five motions can be applied independently and in any combination. The effect of weight bearing on knee flexibility can also be studied by including axial force as one of the five loads. The relative motions are measured with LVDT's and RVDT's, and the loads are measured with strain gage transducers. The system is digitally controlled with a closed feedback loop, allowing for any combination of programmed loads. A control algorithm on an IBM PC/AT monitors the loads on each axis and continuously adjusts stepping motors to correctly follow programmed loads. The machine coordinate system corresponds to clinically accepted definitions of motion yet retains sequence independence for rotations. Results are presented demonstrating the repeatability of using a functional definition of axis placement to align the leg within the machine. Results are also presented demonstrating the utility of the full flexibility functions of the knee, notably in the determination of significant load interactions between anterior/posterior force and internal/external torque, and varus/valgus torque and internal/external torque.