Bone morphology and alignment features are associated with knee kinematics in healthy individuals: A scoping review

The aim of this scoping review was to compose an overview of existing literature on the influence of knee bone morphology and alignment on knee kinematics in healthy individuals.

This review was conducted according to the methodological frameworks of Arksey and O'Malley and Levac et al. and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A systematic PubMed search was performed to identify studies examining associations between knee bone morphology or alignment features and knee kinematics during movement in healthy individuals. Data were charted using a standardised form and categorised and summarised by individual bone (femur, tibia or patella) or as alignment feature.

A total of 2402 studies were initially identified. Following duplicate removal and eligibility screening, 29 studies were included. Knee kinematics were assessed using various techniques, including marker-based motion capture systems and advanced dynamic magnetic resonance imaging (MRI) or computed tomography (CT) imaging, across diverse knee movement tasks. Thirteen femoral and seven tibial bone morphology features demonstrated statistically significant associations with knee kinematics, whereas only two patellar bone morphology features were statistically significantly associated. Additionally, sixteen different alignment features showed statistically significant associations with knee kinematics. The features most frequently associated with knee kinematics included lateral trochlear inclination, tibial slope, tibial tuberosity-trochlear groove distance and static patellar tilt angle.

Although many reported associations were supported by only a limited number of studies, this review provides a comprehensive overview of relationships between knee morphology and kinematics in healthy individuals. The findings highlight the importance of considering bone morphology and alignment in kinematic assessment and contribute to a growing understanding of functional knee anatomy. The influence of patellar bone morphology on knee kinematics remains underinvestigated, underscoring the need for standardised, large-scale studies to further advance clinical assessment and biomechanical understanding.

Level III.