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Related Concept Videos

Functional Classification of Joints01:09

Functional Classification of Joints

Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses  or amphiarthroses, whereas all synovial joints are classified as diarthroses.
Synarthrosis
An immobile...

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In Vivo Classification of Patellar Motion Trajectories in Individuals: A 4D-CT-Based Study with Unsupervised

Jiaying Wei1, Ziyi Jiang2, Xinhao Zhang2

  • 1Orthopaedic Research Laboratory of Chongqing Medical University, Chongqing Municipal Health Commission Key Laboratory of Musculoskeletal Regeneration and Translational Medicine, Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

Diagnostics (Basel, Switzerland)
|May 27, 2026
PubMed
Summary

Asymptomatic knees show three patellar motion trajectory types, primarily determined by lateral translation. This four-dimensional computed tomography (4D-CT) classification offers a dynamic baseline for evaluating patellofemoral joint stability.

Keywords:
artificial intelligencefour-dimensional computed tomographypatellar motion trajectoriespatellofemoral jointunsupervised clustering

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Area of Science:

  • Biomechanics
  • Medical Imaging
  • Orthopedics

Background:

  • Patellar motion trajectory (PMT) is crucial for patellofemoral joint (PFJ) stability.
  • Static imaging cannot capture dynamic six-degrees-of-freedom (6-DOF) patellar motion.
  • Four-dimensional computed tomography (4D-CT) enables in vivo dynamic PFJ imaging, but PMT classification in healthy knees is underexplored.

Purpose of the Study:

  • To systematically classify patellar motion trajectories (PMT) in asymptomatic knees using 4D-CT.
  • To identify distinct PMT phenotypes based on dynamic 6-DOF kinematics.
  • To establish a dynamic kinematic baseline for PFJ stability assessment.

Main Methods:

  • Retrospective analysis of 64 asymptomatic knees undergoing 4D-CT dynamic scanning.
  • Extraction of patellar 6-DOF kinematic data during knee flexion-extension (0°-90°).
  • Unsupervised K-means clustering to classify PMT phenotypes, with nonparametric tests for analysis.

Main Results:

  • Three distinct PMT types were identified: Type 1 (7.81%), Type 2 (56.25%), and Type 3 (35.94%).
  • Lateral translation (Tx) was the dominant factor differentiating PMT types (p < 0.001).
  • Static imaging parameters did not correlate with these dynamic subtypes.

Conclusions:

  • Asymptomatic knees exhibit three distinct in vivo 6-DOF patellar motion trajectory phenotypes.
  • These phenotypes are predominantly characterized by lateral translation amplitude.
  • This 4D-CT typing framework provides a dynamic baseline for PFJ stability evaluation and future research.