Accurate Measurement of Healthy Joint Kinematics to Inform Diagnosis and Treatment

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URL: https://digitalcommons.du.edu/etd/1878/

PROQUEST: 2519757146

Abstract

The description of human motion has a primary importance in different scientific areas such as medicine, sports, physical therapy. Kinematics specifically studies pure motion without reference to the causes of motion such as forces. Understanding the kinematics of human movement is of critical importance in medicine and biology. Motion measurement can be used in order to to evaluate functional performance of limbs under normal and abnormal conditions. Kinematic knowledge is also important for diagnosis and surgical treatment ofjoint disease and the design of implants to rehabilitate function. Accurate joint kinematics is essential to protect articular functionality. An alteration may change the transmission of physiological loads, which could lead to degenerative arthrosis from compartmental overload. Thus, accurate measurement of healthy joint motion is needed to establish baseline kinematics and clinical parameters for assessment of natural joint function, diagnosis of pathology, design oftreatments, and evaluation of patient outcomes. The main aim of human motion analysis is the description of joint kinematics during daily living activity. Accurate quantification of hip/knee kinematics during activities of daily living and differing demand is essential since joint kinematics during functional tasks are influenced by external forces, joint position and the balance of active and passive contributory forces across the joint of interest. Age range has also a significant impact on joint kinematics. Currently, it is unclear what aspects of the kinematic changes appearing with osteoarthritis are the result of the disease or part of natural aging. To our knowledge, no others have evaluated normal knee function for a cohort age matched to total knee arthroplasty (TKA) recipients and during activities that patients with TKA often report to be troublesome, such as descending a step and executing a turn during walking. Most descriptions of knee kinematics have been for younger adults and for a limited span of activities. Additionally, quantitative data of total knee arthroplasty kinematics is crucial for the evaluation of the component failure and for providing guidelines for further advancement of the implant design. TKA is a regular surgical procedure to alleviate pain and restore knee function. Successful functional outcome following TKA is influenced by the geometry and design of the components as well as their interaction with the soft tissue surrounding this articulation. Thus, understanding the effect of design choices on in vivo kinematics and during different dynamic activities of daily living has become more essential since the connection between knee prosthesis kinematics and clinical performance is clearly increasing. Finally, to best of our knowledge no others have investigated and compared the 3D pelvic functional orientation across different populations that include healthy subjects, subjects that have undergone total hip arthroplasty (THA) and spinal-stabilized cohorts and during different static and dynamic activities. Furthermore, most studies have performed their measurements in static settings whereas the pelvic motion is dynamic. The functional orientation of the pelvis varies during different dynamic activities and the pelvis is not a fixed static bone when considering acetabular cup placement. This knowledge will help us to better understand the behavior of all spinopelvic parameters and aid decisions regarding acetabular component alignment. Differences in spinopelvic parameters across different patient populations and across static and dynamic activities are necessary to understand for accurate positioning of the acetabular component during total hip arthroplasty and reduce the likelihood ofimpingement events.

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