Improper patellar tracking is often considered to be the cause of patellar-femoral pain. Unfortunately, our knowledge of patellar-femoral-tibial (knee) joint kinematics is severely limited due to a lack of three-dimensional, noninvasive, in vivo measurement techniques. This study presents the first large-scale, dynamic, three-dimensional, noninvasive, in vivo study of nonimpaired knee joint kinematics during volitional leg extensions. Cine-phase contrast magnetic resonance imaging was used to measure the velocity profiles of the patella, femur, and tibia in 18 unimpaired knees during leg extensions, resisted by a 34 N weight. Bone displacements were calculated through integration and then converted into three-dimensional orientation angles. We found that the patella displaced laterally, superiorly, and anteriorly as the knee extended. Further, patellar flexion lagged knee flexion, patellar tilt was variable, and patellar rotation was fairly constant throughout extension.

1.
Bechtold
J. E.
,
Eastlund
D. T.
,
Butts
M. K.
,
Lagerborg
D. F.
, and
Kyle
R. F.
,
1994
, “
The effects of freeze-drying and ethylene oxide sterilization on the mechanical properties of human patellar tendon
,”
Am. J. Sports Med.
, Vol.
22
, pp.
562
566
.
2.
Brossmann
J.
,
Muhle
C.
,
Schroder
C.
,
Melchert
U. H.
,
Bull
C. C.
,
Spielmann
R. P.
, and
Heller
M.
,
1993
, “
Patellar tracking patterns during active and passive knee extension: evaluation with motion-triggered cine MR imaging
,”
Radiology
, Vol.
187
, pp.
205
212
.
3.
Chao
E. Y.
, and
Money
B. F.
,
1978
, “
Three-dimensional rotation of the elbow
,”
J. Biomech.
, Vol.
11
, pp.
57
73
.
4.
Conway
W. F.
,
Hayes
C. W.
,
Loughran
T.
,
Totty
W. G.
,
Griffeth
L. K.
,
el-Khoury
G. Y.
, and
Shellock
F. G.
,
1991
, “
Cross-sectional imaging of the patellofemoral joint and surrounding structures
,”
Radiographics
, Vol.
11
, pp.
195
217
.
5.
Crisco
J. J.
,
Hentel
K.
,
Wolfe
S. W.
, and
Duncan
J. S.
,
1995
, “
Two-dimensional rigid-body kinematics using image contour registration
,”
J. Biomech.
, Vol.
28
, pp.
119
124
.
6.
Delp, S. L., 1990, “Surgery Simulation: A Computer Graphics System to Analyze and Design Musculoskeletal Reconstructions of the Lower Limb,” Ph.D. Thesis, Stanford University.
7.
Drace
J. E.
, and
Pelc
N. J.
,
1994
a, “
Measurement of skeletal muscle motion in vivo with phase-contrast MR imaging
,”
J. Magn. Reson. Imaging
, Vol.
4
, pp.
157
163
.
8.
Drace
J. E.
, and
Pelc
N. J.
,
1994
b, “
Tracking the motion of skeletal muscle with velocity-encoded MR imaging
,”
J. Magn. Reson. Imaging
, Vol.
4
, pp.
773
778
.
9.
Glover, G. H., and Pelc, N. J., 1988, “A rapid gated cine MRI technique,” in: Magnetic Resonance Annual, 1988 (Kressel, ed.), pp. 299-333, Raven Press, New York.
10.
Grabiner
M. D.
,
Koh
T. J.
, and
Draganich
L. F.
,
1994
, “
Neuromechanics of the patellofemoral joint
,”
Med. Sci. Sports Exerc.
, Vol.
26
, pp.
10
21
.
11.
Grelsamer
R. P.
,
Bazos
A. N.
, and
Proctor
C. S.
,
1993
, “
Radiographic analysis of patellar tilt
,”
J. Bone Joint Surg. Br.
, Vol.
75
, pp.
822
824
.
12.
Haut
R. C.
, and
Powlison
A. C.
,
1990
, “
The effects of test environment and cyclic stretching on the failure properties of human patellar tendons
,”
J. Orthop. Res.
, Vol.
8
, pp.
532
540
.
13.
Heegaard
J.
,
Leyvraz
P. F.
,
Curnier
A.
,
Rakotomanana
L.
, and
Huiskes
R.
,
1995
, “
The biomechanics of the human patella during passive knee flexion
,”
J. Biomech.
, Vol.
28
, pp.
1265
1279
.
14.
Hefzy
M. S.
, and
Yang
H.
,
1993
, “
A three-dimensional anatomical model of the human patello-femoral joint, for the determination of patello-femoral motions and contact characteristics
,”
J. Biomed. Eng.
, Vol.
15
, pp.
289
302
.
15.
Hirokawa
S.
,
1991
, “
Three-dimensional mathematical model analysis of the patellofemoral joint
,”
J. Biomech.
, Vol.
24
, pp.
659
671
.
16.
Inoue
M.
,
Shino
K.
,
Hirose
H.
,
Horibe
S.
, and
Ono
K.
,
1988
, “
Subluxation of the patella. Computed tomography analysis of patellofemoral congruence
,”
J. Bone Joint Surg. [Am.]
, Vol.
70
, pp.
1331
1337
.
17.
Kane, T. R., Likins, P. W., and Levinson, D. A., 1983, Spacecraft Dynamics, McGraw-Hill Book Company, New York.
18.
Kinzel
G. L.
,
Hall
A. S.
, and
Hillberry
B. M.
,
1972
, “
Measurement of the Total Motion Between Two Body Segment—I Analytical Development
,”
J. Biomech.
, Vol.
5
, pp.
93
105
.
19.
Koh
T.
,
Grabiner
M.
, and
De Swart
R.
,
1992
, “
In Vivo Tracking of the Human Patellar
,”
J. Biomech.
, Vol.
25
, pp.
637
643
.
20.
Merchant
A. C.
,
Mercer
R. L.
,
Jacobsen
R. H.
, and
Coll
C. R.
,
1974
, “
Roentgenographic analysis of patellofemoral congruence
,”
J. Bone Joint Surg. [Am.]
, Vol.
56-A
, pp.
1391
1396
.
21.
Murray
P. M.
,
Baldwin
J. M.
,
Gardner
G. M.
,
Sepic
S. B.
, and
Downs
J. W.
,
1977
, “
Maximum isometric knee flexor and extensor muscle contractions
,”
Physical Therapy
, Vol.
57
, pp.
637
643
.
22.
Nagamine
R.
,
Otani
T.
,
White
S. E.
,
McCarthy
D. S.
, and
Whiteside
L. A.
,
1995
, “
Patellar tracking measurement in the normal knee
,”
J. Orthop. Res.
, Vol.
13
, pp.
115
122
.
23.
Pelc
N. J.
,
Drangova
M.
,
Pelc
L. R.
,
Zhu
Y.
,
Noll
D. C.
,
Bowman
B. S.
, and
Herfkens
R. J.
,
1995
, “
Tracking of cyclic motion with phase-contrast cine MR velocity data
,”
J. Magn. Reson. Imaging
, Vol.
5
, pp.
339
345
.
24.
Pelc
N. J.
,
Sommer
F. G.
,
Li
K. C.
,
Brosnan
T. J.
,
Herfkens
R. J.
, and
Enzmann
D. R.
,
1994
, “
Quantitative magnetic resonance flow imaging
,”
Magn. Reson. Q.
, Vol.
10
, pp.
125
147
.
25.
Sheehan, F. T., 1997, “A non-invasive in-vivo study of the patella using cine phase contrast magnetic resonance imaging: 3D kinematics and tendon strain,” Ph.D. Thesis, Stanford University, Stanford, California.
26.
Sheehan
F. T.
,
Zajac
F. E.
, and
Drace
J. E.
,
1998
, “
Using cine phase contrast magnetic resonance imaging to non-invasively study in vivo knee dynamics
,”
J. Biomech.
, Vol.
31
, pp.
21
26
.
27.
Sheehan, F. T., and Mitiguy, P., 1999, “In regards to the ‘ISB recommendations for standardization in the reporting of kinematic data’,” J. Biomech.
28.
Spoor
C. W.
, and
Veldpaus
F. E.
,
1980
, “
Rigid body motion calculated from spatial co-ordinates of markers
,”
J. Biomech.
, Vol.
13
, pp.
391
393
.
29.
van Eijden
T. M.
,
Kouwenhoven
E.
, and
Weijs
W. A.
,
1987
, “
Mechanics of the patellar articulation. Effects of patellar ligament length studied with a mathematical model
,”
Acta Orthop. Scand.
, Vol.
58
, pp.
560
566
.
30.
van Kampen
A.
, and
Huiskes
R.
,
1990
, “
The three-dimensional tracking pattern of the human patella
,”
J. Orthop. Res.
, Vol.
8
, pp.
372
382
.
31.
Winters, D. A., 1979, Biomechanics of Human Movement, Whiley, New York.
32.
Wu
G.
, and
Cavanagh
P. R.
,
1995
, “
ISB recommendations for standardization in the reporting of kinematic data
,”
J. Biomech.
, Vol.
28
, pp.
1257
1261
.
33.
Yamaguchi
G. T.
, and
Zajac
F. E.
,
1989
, “
A planar model of the knee joint to characterize the knee extensor mechanism
,”
J. Biomech.
, Vol.
22
, pp.
1
10
.
34.
Zhu
Y.
,
Drangova
M.
, and
Pelc
N. J.
,
1996
, “
Fourier tracking of myocardial motion using cine-PC data
,”
Magn. Reson. Med.
, Vol.
35
, pp.
471
480
.
This content is only available via PDF.
You do not currently have access to this content.