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The description of the human knee as four-bar linkage

Dathe H., Gezzi R., Fiedler Ch., Kubein-Meesenburg D., Nägerl H.

Acta of Bioengineering and Biomechanics

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2016

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Vol. 18, no. 4

107--115

EN

Purpose: We investigate the dependence of the kinematics of the human knee on its anatomy. The idea of describing the kinematics of the knee in the sagittal plane using four-bar linkage is almost as old as kinematics as an independent discipline. We start with a comparison of known four-bar linkage constructions. We then focus on the model by H. Nägerl which is applicable under form closure. Methods: We use geometry and analysis as the mathematical methods. The relevant geometrical parameters of the knee will be determined on the basis of the dimensions of the four-bar linkage. This leads to a system of nonlinear equations. Results: The four-bar linkage will be calculated from the limits of the constructively accessible parameters by means of a quadratic approximation. Conclusions: By adapting these requirements to the dimensions of the human knee, it will be possible to obtain valuable indications for the design of an endoprosthesis which imitates the kinematics of the natural knee.

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The morphology of the articular surfaces of biological knee joints provides essential guidance for the construction of functional knee endoprostheses

Nagerl H., Dathe H., Fiedler Ch., Gowers L., Kirsch S., Kubein-Meesenburg D., Dumont C., Wachowski M. M.

Acta of Bioengineering and Biomechanics

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2015

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Vol. 17, no. 2

45--53

EN

Purpose: In comparative examinations of kinematics of the knees of humans and pigs in flexional/extensional motion under compressive loads, the significant differential geometric essentials of articular guidance are elaborated to criticise the shaping of the articular surfaces of conventional knee-endoprostheses and to suggest constructional outlines that allow the endoprosthesis to adopt natural knee kinematics. Implantation is discussed with regard to the remaining ligamentous apparatus. Methods: Twelve fresh pig knee joints and 19 preserved human knee joints were moved into several flexional/extensional positions. In each joint, the tibia and femur were repeatably caught by metal plates. After removing all ligaments, the tibia and femur were again caught in these positions, and their points of contact were marked on both articular surfaces. Along the marker points, a thin lead wire was glued onto each surface. The positions and shapes of the four contact lines were mapped by teleradiography. Results: All contact lines were found to be plane curves. The medial and lateral planes were parallel, thus defining the joint’s sagittal plane. In the human knee, as compared to the lateral, the medial femoral contact line was always shifted anteriorly by several millimetres. The tibial contact curve was laterally convex and medially concave. In the pig knees, the lateral and medial contact lines were asymmetrically placed. Both tibial curves were convex. Conclusions: Both knees represent cam mechanisms (with one degree of freedom) that produce rolling of the articular surfaces during the stance phase. Implantation requires preservation of the anterior cruciate ligament, and ligamentous balancing is disadvantageous.

3

Mathematical study on the guidance of the tibiofemoral joint as theoretical background for total knee replacements

Fiedler Ch., Gezzi R., Frosch K.-H., Wachowski M. M., Kubein-Meesenburg D., Dörner J., Fanghänel J., Nägerl H.

Acta of Bioengineering and Biomechanics

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2011

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Vol. 13, no. 4

37-49

EN

The mathematical approach presented allows main features of kinematics and force transfer in the loaded natural tibiofemoral joint (TFJ) or in loaded knee endoprostheses with asymmetric condyles to be deduced from the spatial curvature morphology of the articulating surfaces. The mathematical considerations provide the theoretical background for the development of total knee replacements (TKR) which closely reproduce biomechanical features of the natural TFJ. The model demonstrates that in flexion/extension such kinematic features as centrodes or slip ratios can be implemented in distinct curvature designs of the contact trajectories in such a way that they conform to the kinematics of the natural TFJ in close approximation. Especially the natural roll back in the stance phase during gait can be reproduced. Any external compressive force system, applied to the TFJ or the TKR, produces two joint reaction forces which - when applying screw theory - represent a force wrench. It consists of a force featuring a distinct spatial location of its line and a torque parallel to it. The dependence of the geometrical configuration of the force wrench on flexion angle, lateral/medial distribution of the joint forces, and design of the slopes of the tuberculum intercondylare is calculated. The mathematical considerations give strong hints about TKR design and show how main biomechanical features of the natural TFJ can be reproduced.