In vivo normal knee kinematics: is ethnicity or gender an influencing factor?
BACKGROUND
In vivo studies have suggested Caucasians achieve lower average knee flexion than non-Western populations. Some previous studies have also suggested gender may influence condylar AP translation and axial rotation, while others report an absence of such an influence.


OBJECTIVE
We determined whether different ethnic and gender groups residing in the United States had different knee translations and rotations.


METHODS
Three-dimensional knee rotations and translations were determined for 72 healthy subjects (24 Caucasian men, 24 Caucasian women, 13 Japanese men, 11 Japanese women) from full extension to maximum flexion using a fluoroscopic technique, under in vivo, weightbearing conditions.


RESULTS
Although we observed substantial variability in all groups, small differences between groups were found, especially in deep flexion. Japanese women and men and Caucasian women achieved higher maximum flexion (153°, 151°, and 152°, respectively) than Caucasian men (146°). External rotation was higher for these three groups than for Caucasian men. The medial condyle remained more anterior for Caucasian women and all Japanese subjects than for Caucasian men, possibly leading to greater axial rotation and flexion, observed for these three groups.


CONCLUSIONS
We identified small differences in maximum flexion between genders and ethnic groups. While no differences were identified in the lateral condyle translation, the medial condyle remained more stationary and more anterior for the groups that achieved highest (and similar) maximum flexion. Therefore, it may be important for future implant designs to incorporate these characteristics, such that only the lateral condyle experiences greater posterior femoral rollback, while the medial condyle remains more stationary throughout flexion.
Leszko
Filip
F
University of Tennessee, 301 Perkins Hall, Knoxville, TN 37996-2030, USA.
Hovinga
Kristen R
KR
Lerner
Amy L
AL
Komistek
Richard D
RD
Mahfouz
Mohamed R
MR
D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation; D044466:Asian People; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007564:Japan; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology*; D007720:Knee Prosthesis; D008297:Male; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D016059:Range of Motion, Articular; D012016:Reference Values; D012737:Sex Factors; D014481:United States; D016474:Weight-Bearing; D044465:White People; D055815:Young Adult
J Bone Joint Surg Br. 2000 Nov;82(8):1189-95
11132285
J Anat. 1992 Apr;180 ( Pt 2):297-304
1506284
J Orthop Res. 2009 Jul;27(7):871-8
19127520
Clin Orthop Relat Res. 2001 Jul;(388):157-66
11451115
J Bone Joint Surg Br. 2000 Nov;82(8):1199-200
11132287
J Biomech. 2005 Feb;38(2):255-62
15598451
Clin Orthop Relat Res. 2003 May;(410):69-81
12771818
Clin Orthop Relat Res. 2003 Aug;(413):208-21
12897612
J Bone Joint Surg Am. 2002 Jan;84(1):10-6
11792773
Arthroscopy. 2004 Jul;20(6):564-71
15241305
J Athl Train. 1999 Apr;34(2):144-9
16558557
Med Eng Phys. 1998 Jun;20(4):302-7
9728681
IEEE Trans Med Imaging. 2003 Dec;22(12):1561-74
14649746
Am J Sports Med. 2006 May;34(5):765-70
16399932
Clin Biomech (Bristol, Avon). 2003 Aug;18(7):662-9
12880714
Clin Orthop Relat Res. 2003 May;(410):44-53
12771816
Acta Orthop Scand. 1966;37(1):97-106
5940062
Acta Orthop Scand. 1982 Apr;53(2):205-8
7136564
J Orthop Res. 2006 Apr;24(4):770-81
16514664
Am J Sports Med. 2003 May-Jun;31(3):449-56
12750142
Clin Biomech (Bristol, Avon). 2006 Dec;21(10):1060-6
16949187
J Arthroplasty. 2002 Feb;17(2):209-16
11847622
J Biomech. 2005 Feb;38(2):269-76
15598453
Clin Orthop Relat Res. 2003 May;(410):35-43
12771815
J Bone Joint Surg Am. 1992 Aug;74(7):980-6
1522105
J Orthop Res. 2009 Sep;27(9):1191-6
19242980
Clin Biomech (Bristol, Avon). 1998 Oct;13(7):455-472
11415822
J Bone Joint Surg Br. 2002 May;84(4):607-13
12043788
Clin Sports Med. 1991 Jan;10(1):63-86
2015647
Arthritis Rheum. 1999 May;42(5):861-70
10323441
J Arthroplasty. 2005 Sep;20(6):777-83
16139716
J Biomech. 2005 Feb;38(2):197-208
15598446
J Biomech. 2005 Feb;38(2):241-53
15598450
J Biomech. 2004 Oct;37(10):1499-504
15336924
Clin Orthop Relat Res. 1998 Nov;(356):47-57
9917667
Clin Orthop Relat Res. 1988 Sep;(234):229-31
3409581
Am J Sports Med. 2002 Mar-Apr;30(2):261-7
11912098
Clin Orthop Relat Res. 2005 Feb;(431):157-65
15685070
J Bone Joint Surg Am. 2003 May;85(5):782-9
12728025
J Biomech Eng. 1983 May;105(2):136-44
6865355
Clin Orthop Relat Res. 1996 Oct;(331):107-17
8895626
J Bone Joint Surg Am. 2004;86-A Suppl 2:56-61
15691109
J Arthroplasty. 2008 Oct;23(7):1057-67
18534487
Trop Doct. 1989 Jan;19(1):21-4
2922809
Clin Orthop Relat Res. 2001 Sep;(390):182-9
11550865
Clin Biomech (Bristol, Avon). 2001 Jun;16(5):438-45
11390052
J Anat. 1953 Apr;87(2):91-5
13044721