In Vitro Simulation of Deep Knee Flexion Using Static and Dynamic Machines

Experimental testing with cadaveric tissue allows the application of controlled loads and/or motions while still maintaining the inherent variability in the anatomy and soft tissue of the specimens. Multi-axial dynamic loading of tissue allows for experiments to be conducted that simulate conditions approaching physiological. Knee simulators have been used to generate physiological loading on the human knee to study kinematics, soft tissue loading, and joint contact pressure. These machines have been used to investigate injury, surgical outcomes, and prosthetic design. While there are a number of different geometries for knee loading devices, most are based on the Oxford rig design [1] with a vertical orientation of the leg where the hip is able to translate up and down while allowing flexion at the hip, knee, and ankle. The foot or ankle can have a variety of constraints and degrees of freedom. One of the recent areas of interest in knee biomechanics is the role different structures of the knee play during deep knee flexion activities. This is of particular interest to the orthopedic industry because of the common complaint regarding a feeling of a loss of stability during high flexion activities for post-TKR patients and the prevalence of high-flexion activities in emerging worldwide markets. The objective of this abstract is to describe two knee loading devices that have been used to study knee biomechanics, and most recently high flexion motion, and present some representative data from these tools.