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Assessment of Knee Kinematics in Older Adults Using High-Speed Stereo Radiography

KEFALA, VASILIKI1; CYR, ADAM J.1; HARRIS, MICHAEL D.1; HUME, DONALD R.1; DAVIDSON, BRADLEY S.1; KIM, RAYMOND H.1,2; SHELBURNE, KEVIN B.1

Medicine & Science in Sports & Exercise: November 2017 - Volume 49 - Issue 11 - p 2260–2267
doi: 10.1249/MSS.0000000000001350
Applied Sciences

Purpose: Quantification of knee motion is essential for assessment of pathologic joint function, such as tracking osteoarthritis progression and evaluating outcomes after conservative or surgical treatment, including total knee arthroplasty. Our purpose was to establish a useful baseline for the kinematic envelope of knee motion in healthy older adults performing movements of daily living.

Methods: A high-speed stereo radiography system was used to measure the three-dimensional tibiofemoral kinematics of eight healthy people over 55 yr of age (4 women/4 men; age, 61.7 ± 5.4 yr; body mass, 74.6 ± 7.7 kg; body mass index, 26.7 ± 4.4 kg·m−2; height, 168.2 ± 13.7 cm) during seated knee extension, level walking, pivoting, and step descent.

Results: Internal–external and varus–valgus rotation and anterior–posterior range of motion through stance in normal walking averaged 3.6° ± 1.1°, 2.3° ± 0.6°, and 3.4 ± 1.57 mm, respectively. Average range of motion across subjects was greater during the step-down in both internal–external rotation (average, 6.5° ± 3.1°) and anterior–posterior translation (average, 4.5 ± 1.1). Average internal–external range of motion increased to 13.5° ± 3.6° during pivoting. Range of motion of the knee in varus–valgus rotation was nearly the same for each subject across activities, rarely exceeding 6°.

Conclusions: Pivoting and step descending during walking had greater internal–external rotation and anterior–posterior translation than normal gait. Internal–external rotation and anterior–posterior translation were shown to have greater activity dependence, whereas varus–valgus rotation was consistent across activities. These results were similar to prior measurements in younger cohorts, though a trend toward reduced range of motion in the older adults was observed.

1Center for Orthopaedic Biomechanics, The University of Denver, CO; and 2Colorado Joint Replacement, Denver, CO

Address for correspondence: Kevin B. Shelburne, Ph.D., Department of Mechanical and Materials Engineering, The University of Denver, 2390S. York St., Denver, CO 80208; E-mail: kevin.shelburne@du.edu.

Submitted for publication September 2016.

Accepted for publication May 2017.

© 2017 American College of Sports Medicine