Screw-Home Movement of the Tibiofemoral Joint during Normal Gait: Three-Dimensional Analysis.
BACKGROUND
The purpose of this study was to evaluate the screw-home movement at the tibiofemoral joint during normal gait by utilizing the 3-dimensional motion capture technique.


METHODS
Fifteen young males and fifteen young females (total 60 knee joints) who had no history of musculoskeletal disease or a particular gait problem were included in this study. Two more markers were attached to the subject in addition to the Helen-Hayes marker set. Thus, two virtual planes, femoral coronal plane (P f ) and tibial coronal plane (P t ), were created by Skeletal Builder software. This study measured the 3-dimensional knee joint movement in the sagittal, coronal, and transverse planes of these two virtual planes (P f and P t ) during normal gait.


RESULTS
With respect to kinematics and kinetics, both males and females showed normal adult gait patterns, and the mean difference in the temporal gait parameters was not statistically significant (p > 0.05). In the transverse plane, the screw-home movement occurred as expected during the pre-swing phase and the late-swing phase at an angle of about 17°. However, the tibia rotated externally with respect to the femur, rather than internally, while the knee joint started to flex during the loading response (paradoxical screw-home movement), and the angle was 6°.


CONCLUSIONS
Paradoxical screw-home movement may be an important mechanism that provides stability to the knee joint during the remaining stance phase. Obtaining the kinematic values of the knee joint during gait can be useful in diagnosing and treating the pathological knee joints.
Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
Ha Yong
HY
Kim
Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
Kap Jung
KJ
Kim
Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
Dae Suk
DS
Yang
Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
Sang Wook
SW
Jeung
Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
Han Gyeol
HG
Choi
Department of Orthopedic Surgery, Eulji University College of Medicine, Daejeon, Korea.
Won Sik
WS
Choy
D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena / Q000502:physiology; D005260:Female; D057918:Fiducial Markers; D005684:Gait / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007719:Knee Joint / Q000502:physiology*; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology*; D012737:Sex Factors; D016138:Walking / Q000502:physiology; D055815:Young Adult
Gait; Kinematics; Kinetics