Evidence map›Paper›PMID 26777272›Full record

ArticleClinical biomechanics (Bristol, Avon)2016

In-vivo analysis of flexion axes of the knee: Femoral condylar motion during dynamic knee flexion.

Yong Feng, Tsung-Yuan Tsai, Jing-Sheng Li, Harry E Rubash, Guoan Li, Andrew Freiberg

Abstract read
In one paragraph

Article in Clinical biomechanics (Bristol, Avon), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

  1. Evaluation of a novel robotic testing method for stability and kinematics of total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025
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  11. The inclination of the femoral medial posterior condyle was almost vertical and that of the lateral was tilted medially.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yong FengDepartment of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Fengyongxsh@gmail.com.
Tsung-Yuan TsaiBioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Tsai.Tsung-Yuan@mgh.harvard.edu.
Jing-Sheng LiBioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Li.Jing-Sheng@mgh.harvard.edu.
Harry E RubashBioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Hrubash@partners.org.
Guoan LiBioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Li.Guoan@mgh.harvard.edu.
Andrew FreibergBioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital/Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114, United States. Electronic address: Afreiberg@mgh.harvard.edu.

Funding

In vivo ACL Reconstruction BiomechanicsR01AR055612 · NIAMS · MASSACHUSETTS GENERAL HOSPITAL · PI LI, GUOAN · 2008 to 2012
$1.9M
NIAMS NIH HHS R01 AR055612NIAMS NIH HHS R01AR055612
6 · The paper itself

Abstract

backgroundTransepicondylar axis and geometrical center axis are widely used for investigation of the knee kinematics and component alignment in total knee arthroplasty. However, the kinematic characteristics of these knee axes are not well defined in literature. This study investigated the femoral condylar motion during a dynamic flexion of the knee using different flexion axes.

methodsTwenty healthy knees (10 males and 10 females) were CT scanned to create 3D anatomic models. The subjects performed a single leg flexion from full extension to maximum flexion while the knees were imaged using fluoroscopes. The femoral condyle translations in anterior-posterior and proximal-distal directions were described using clinical transepicondylar axis, surgical transepicondylar axis and geometrical center axis.

findingsThe subjects achieved -9.4° (SD 3.0°) hyperextension at full extension and 116.4° (SD 9.0°) at maximum flexion of the knee. The anterior-posterior translations of the three flexion axes were different for the medial condyle, but similar for the lateral condyle. Substantial variations of the condylar motion in proximal-distal direction were measured along the flexion path using these axes. While the surgical transepicondylar axis maintained condyle heights from full extension to 60° of flexion, geometrical center axis showed little changes in condyle heights from 30° to maximum knee flexion. The condyles moved distally beyond 90° flexion using both transepicondylar axes.

interpretationThe femoral condylar motion measurement is sensitive to the selection of flexion axis. The different kinematic features of these axes provide an insightful reference when selecting a flexion axis in total knee arthroplasty component alignment.

Indexed as

Range of Motion, ArticularAdultArthroplasty, Replacement, KneeBiomechanical PhenomenaBody Mass IndexFemaleFemurFluoroscopyHumansImaging, Three-DimensionalKnee JointMaleModels, AnatomicMotionYoung AdultClinical transepicondylar axisCondylar motionFluoroscopyGeometrical center axisKnee kinematicsSurgical transepicondylar axis

Identifiers

PMID26777272
PMCPMC4779404

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.