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Four-Dimensional CT Analysis Using Sequential 3D-3D Registration

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A Novel Radiographic Methodology to Measure Knee Adduction Moment Using Routine Biplane Radiographs: Initial Results

Fernando J Quevedo Gonzalez¹, Peter K Sculco², Theofilos Karasavvidis²

¹Department of Biomechanics, Hospital for Special Surgery, New York, New York.

The Journal of Arthroplasty

|March 13, 2025

Summary

A new radiographic method accurately measures knee joint moments after total knee arthroplasty, but these moments did not correlate with patient-reported outcomes in this short-term study.

Keywords:

KOOS JR biplane radiographs gait analysis knee adduction moment total knee arthroplasty

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In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy

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Published on: July 2, 2021

Area of Science:

Orthopedics
Biomechanics
Radiology

Background:

Patient dissatisfaction after total knee arthroplasty (TKA) is often linked to compromised function.
Objective functional evaluation typically requires specialized, costly, and time-consuming motion analysis.
A practical radiographic method is needed to assess knee function in routine clinical settings.

Purpose of the Study:

To develop and validate a radiographic method for quantifying knee joint moments during routine clinical care.
To explore the relationship between knee moments and patient-reported outcomes (KOOS JR) after TKA.

Main Methods:

Collected synchronized biplane radiographs and ground force data during walking and static stances in 20 TKA patients (pre- and post-op).
Calculated the knee adduction moment (KAM) from radiographic and dynamic data.
Correlated radiographic KAM with dynamic KAM and the Knee Osteoarthritis Outcomes Score for Joint Replacement (KOOS JR).

Main Results:

Radiographic KAM, especially during single leg stance, strongly correlated with peak dynamic KAM.
Peak dynamic KAM ranged from -0.5 to 4.3% BW·H preoperatively and 1 to 4.4% BW·H postoperatively.
No significant correlation was found between KAM and KOOS JR scores.

Conclusions:

Radiographic KAM serves as a reliable surrogate for dynamic KAM, enabling clinical assessment.
While KAM did not correlate with KOOS JR in this short-term study, further research with longer follow-up and additional metrics is warranted.
This radiographic approach facilitates routine clinical evaluation of knee kinetics to complement patient-reported outcomes.