Helical axes of passive knee joint motions

The purpose of this study was to determine finite helical axes for passive knee joint motions in vitro and to evaluate the descriptive value of the finite helical axes for step-by-step flexion motions, with respect to consistency and reproducibility. An accurate Roentgenstereophotogrammetric system was used for motion measurements. Four knees were tested in a motion and loading rig with one and the same experimental protocol. A fifth specimen was used to study the effects of some of the experimental conditions on the axis parameters. On the basis of earlier reported motion characteristics in terms of Euler rotations and translations, two motion pathways were chosen to be reported here: a flexion motion with an internal torque of 3 Nm and one with an external torque of 3 Nm on the tibia. The positions and orientations of the axes were described relative to the insertions of the four major ligaments and the geometry of the articular surfaces of the femur, and also as intersections with a medial and a lateral sagittal plane. The three-dimensional patterns of the helical axes of the four knee specimens were found to be highly reproducible and consistent for each of the two motion pathways. The axis patterns were not unique, but reflected the particular combination of flexion and axial rotation for each particular motion pathway. Although small, the helical translations indicated medial motions of the tibia relative to the femur. This medial helical translation was more pronounced for the internal pathway compared with the external pathway. Above 70 degrees flexion, the axes move posteriorly relative to the femur.