Measurement of the screw-home motion of the knee is sensitive to errors in axis alignment

Piazza, Stephen J.; Cavanagh, Peter R.

Affiliations

¹Center for Locomotion Studies, Pennsylvania State University, 29 Recreation Building, University Park, PA 16802 and Hershey, PA 17033, USA

²Department of Kinesiology, Pennsylvania State University, 29 Recreation Building, University Park, PA 16802 and Hershey PA 17033, USA

³Department of Mechanical & Nuclear Engineering, Pennsylvania State University, 29 Recreation Building, University Park, PA 16802 and Hershey PA 17033, USA

⁴Department of Biobehavioral Health, Pennsylvania State University, 29 Recreation Building, University Park, PA 16802 and Hershey PA 17033, USA

⁵Department of Medicine, Pennsylvania State University, 29 Recreation Building, University Park, PA 16802 and Hershey PA 17033, USA

⁶Department of Orthopaedics and Rehabilitation, Pennsylvania State University, 29 Recreation Building, University Park, PA 16802 and Hershey PA, 17033, USA

Abstract and keywords

Measurements of joint angles during motion analysis are subject to error caused by kinematic crosstalk, that is, one joint rotation (e.g., flexion) being interpreted as another (e.g., abduction). Kinematic crosstalk results from the chosen joint coordinate system being misaligned with the axes about which rotations are assumed to occur. The aim of this paper is to demonstrate that measurement of the so-called “screw-home” motion of the human knee, in which axial rotation and extension are coupled, is especially prone to errors due to crosstalk. The motions of two different two-segment mechanical linkages were examined to study the effects of crosstalk. The segments of the first linkage (NSH) were connected by a revolute joint, but the second linkage (SH) incorporated gearing that caused 15° of screw-home rotation to occur with 90° knee flexion. It was found that rotating the flexion axis (inducing crosstalk) could make linkage NSH appear to exhibit a screw-home motion and that a different rotation of the flexion axis could make linkage SH apparently exhibit pure flexion. These findings suggest that the measurement of screw-home rotation may be strongly influenced by errors in the location of the flexion axis. The magnitudes of these displacements of the flexion axis were consistent with the inter-observer variability seen when five experienced observers defined the flexion axis by palpating the medial and lateral femoral epicondyles. Care should be taken when interpreting small internal–external rotations and abduction–adduction angles to ensure that they are not the products of kinematic crosstalk.

Keywords: Screw-home; Knee kinematics; Motion analysis; Flexion axis; Kinematic crossstalk

Links

DOI: 10.1016/S0021-9290(00)00056-7

PubMed: 10828334

WoS: 000087474600015

History

Accepted: 2000-02-22

Cited Works (9)

Year	Entry
1995	Cappozzo A, Catani F, Della Croce U, Leardini A. Position and orientation in space of bones during movement: anatomical frame definition and determination. Clin Biomech (Bristol, Avon). June 1995;10(4):171-178.
1988	Blankevoort L, Huiskes R, de Lange A. The envelope of passive knee joint motion. J Biomech. 1988;21(9):705-720.
1983	Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.
1976	Trent PS, Walker PS, Wolf B. Ligament length patterns, strength, and rotational axes of the knee joint. Clin Orthop Relat Res. June 1976;117:263-270.
1985	Kurosawa H, Walker P., Abe S, Garg A, Hunter T. Geometry and motion of the knee for implant and orthotic design. J Biomech. 1985;18(7):487-499.
1948	Levens AS, Inman VT, Blosser JA. Transverse rotation of the segments of the lower extremity in locomotion. J Bone Joint Surg. October 1948;30A(4):859-872.
1990	Kadaba MP, Ramakrishnan HK, Wootten ME. Measurement of lower extremity kinematics during level walking. J Orthop Res. May 1990;8(3):383-392.
1995	Challis JH. A procedure for determining rigid body transformation parameters. J Biomech. June 1995;28(6):733-737.
1992	Lafortune MA, Cavanagh PR, Sommer HJ III, Kalenak A. Three-dimensional kinematics of the human knee during walking. J Biomech. April 1992;25(4):347-357.

Cited By (23)

Year	Entry
2008	Glasoe W, Pena F, Phadke V, Ludewig PM. Arch height and first metatarsal joint axis orientation as related variables in foot structure and function. Foot Ankle Int. 2008;29(6):647-654.
2005	Della Croce U, Leardini A, Chiari L, Cappozzo A. Human movement analysis using stereophotogrammetry, IV: assessment of anatomical landmark misplacement and its effects on joint kinematics. Gait Post. February 2005;21(2):226-237.
2005	Schwartz MH, Rozumalski A. A new method for estimating joint parameters from motion data. J Biomech. January 2005;38(1):107-116.
2007	Landry SC, McKean KA, Hubley-Kozey CL, Stanish WD, Deluzio KJ. Knee biomechanics of moderate OA patients measured during gait at a self-selected and fast walking speed. J Biomech. 2007;40(8):1754-1761.
2023	Nijmeijer EM, Heuvelmans P, Bolt R, Gokeler A, Otten E, Benjaminse A. Concurrent validation of the Xsens IMU system of lower-body kinematics in jump-landing and change-of-direction tasks. J Biomech. June 2023;154:111637.
2008	Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ. Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. J Orthop Res. March 2008;26(3):332-341.
2004	McLean SG, Lipfert SW, Van Den Bogert AJ. Effect of gender and defensive opponent on the biomechanics of sidestep cutting. Med Sci Sports Exer. 2004;36(6):1008-1016.
2007	Astephen JL. Biomechanical Factors in the Progression of Knee Osteoarthritis [PhD thesis]. Halifax, NS: Dalhousie University; October 2007.
2007	Landry CNS. Biomechanical and Neuromuscular Differences Exist Between Genders for Unanticipated Running and Cutting Maneuvers in Adolescent Soccer Players: Relevance to the ACL [PhD thesis]. Halifax, NS: Dalhousie University; March 2007.
2011	Conrad J. The Biomechanical Effects of an Externally Applied Orthosis on Medial Compartment Knee Osteoarthritis [Master's thesis]. Halifax, NS: Dalhousie University; December 2011.
2012	Harding GT. Obesity, Moderate Knee Osteoarthritis, and Knee Joint Dynamics [Master's thesis]. Halifax, NS: Dalhousie University; July 2012.
2013	Young KL. Patient-Specific Patterns of Passive and Dynamic Knee Joint Mechanics Before and After Total Knee Arthroplasty [Master's thesis]. Halifax, NS: Dalhousie University; July 2013.
2017	Outerleys J. Modeling the Patient Variability and Hierarchy in Joint-Level Kinematic and Kinetic Function Before and After Primary Total Knee Arthroplasty Surgery [Master's thesis]. Halifax, NS: Dalhousie University; March 2017.
2007	Halloran JP. Explicit Finite Element Modeling of Total Knee Replacement Mechanics [PhD thesis]. University of Denver; June 2007.
2007	Peeke K. Study of Alignment in Total Knee Arthroplasty Around a Single Flexion Axis Evaluated for Helical and Conical Axes [Master's thesis]. Colorado School of Mines; 2007.
2020	Horenstein RE. Mechanisms of Cam Morphology of the Proximal Femur [PhD thesis]. Northeastern University; May 2020.
2002	Moglo KE. Analyse non linéaire par éléments finis du genou humain sous charges complexes en flexion [PhD thesis]. École polytechnique de Montréal; October 2002.
2000	Ladouceur DT. Three-Dimensional Kinematics of Seven Activities of Daily Living Commonly Found in Asia [Master's thesis]. Queen's University; August 2000.
2018	Clouthier AL. The Relationship Between Knee Joint Shape and Function: Implications for Pathology and Treatment [PhD thesis]. Queen's University; September 2018.
2013	Bonny DP. Design, Calibration, and Validation of an Instrumented Spatial Linkage That Accurately Measures Changes in the Rotational Axes of the Tibiofemoral Joint [Master's thesis]. Davis, University of California; 2013.
2022	Young C. 3D Printed Wearable Devices for Out-of-Lab Joint Performance Assessment: Design, Validation and Applications [PhD thesis]. University of Guelph; August 2022.
2011	Ferreira LM. Development of an Active Elbow Motion Simulator and Coordinate Systems to Evaluate Kinematics in Multiple Positions [PhD thesis]. University of Western Ontario; 2011.
2016	Manocha RHK. Optimizing the Rehabilitation of Elbow Lateral Collateral Ligament Injuries [Master's thesis]. University of Western Ontario; 2016.