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Leffler J.,Klinik fur Orthopadie und Sporttraumatologie | Scheys L.,European Center for Knee Research | Plante-Bordeneuve T.,University Hospital Leuven campus | Callewaert B.,Catholic University of Leuven | And 3 more authors.
Gait and Posture

In many cases knee osteoarthritis leads to total knee replacement surgery (TKR) even if the lateral compartment is not involved. More recently, a bicompartmental knee replacement system (BKR) (Journey Deuce, Smith & Nephew Inc., Memphis, TN, USA) has been developed that only replaces the medial tibiofemoral and the patellofemoral compartments, thus preserving both cruciate ligaments with its associated benefits. However information on the effect of BKR on in vivo knee joint kinematics is not widely available in the literature.Therefore, this study analyzed full three-dimensional knee joint kinematics in 10 postoperative BKR-subjects for a broad spectrum of relevant daily life activities: walking, walking followed by a cross-over or sidestep turn, step ascent and descent, mild squatting and chair rise. We analyzed to what extent normal knee motion is regained through comparison with their non-involved limb as well as a group of matched controls. Furthermore, coefficients of multiple correlation were calculated to assess the consistency of knee joint kinematics both within and between subject groups.This analysis demonstrated that, despite the presence of differences indicative for retention of pre-operative motion patterns and/or remaining compensations, knee joint kinematics in BKR limbs replicate, for a large range of daily-life motor tasks, the kinematics of the contra-lateral non-affected limbs and healthy controls to a similar extent as they are replicated within both these control groups. © 2012 Elsevier B.V. Source

Scheys L.,University Hospital Leuven campus | Scheys L.,Catholic University of Leuven | Desloovere K.,University Hospital Leuven Campus Pellenberg | Spaepen A.,Catholic University of Leuven | And 2 more authors.
Gait and Posture

Rescaling generic models is the most frequently applied approach in generating biomechanical models for inverse kinematics. Nevertheless it is well known that this procedure introduces errors in calculated gait kinematics due to: (1) errors associated with palpation of anatomical landmarks, (2) inaccuracies in the definition of joint coordinate systems. Based on magnetic resonance (MR) images, more accurate, subject-specific kinematic models can be built that are significantly less sensitive to both error types.We studied the difference between the two modelling techniques by quantifying differences in calculated hip and knee joint kinematics during gait. In a clinically relevant patient group of 7 pediatric cerebral palsy (CP) subjects with increased femoral anteversion, gait kinematic were calculated using (1) rescaled generic kinematic models and (2) subject-specific MR-based models. In addition, both sets of kinematics were compared to those obtained using the standard clinical data processing workflow.Inverse kinematics, calculated using rescaled generic models or the standard clinical workflow, differed largely compared to kinematics calculated using subject-specific MR-based kinematic models. The kinematic differences were most pronounced in the sagittal and transverse planes (hip and knee flexion, hip rotation). This study shows that MR-based kinematic models improve the reliability of gait kinematics, compared to generic models based on normal subjects. This is the case especially in CP subjects where bony deformations may alter the relative configuration of joint coordinate systems. Whilst high cost impedes the implementation of this modeling technique, our results demonstrate that efforts should be made to improve the level of subject-specific detail in the joint axes determination. © 2010 Elsevier B.V. Source

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