The primary arthrokinematics of the tibiofemoral …...Tibiofemoral Arthrokinematics The primary...

TibiofemoralArthrokinematics

Theprimaryarthrokinematicsofthetibiofemoraljointincluderoll,glideandspin.Rollingisasagittalplanerotation;gliding,asagittalplanetranslation;andspin,atransverseplanerotation.Thesemovementsare

combinedtomaintainjointcontactandstabilityduringflexionandextension.

RollandGlide

Anteriorcruciateligament(ACL)tensionincreasesduringflexion,initiatinganteriorfemoralglide/translation;conversely,posteriorcruciateligament(PCL)tensionincreasesduringextension,resultinginposteriorfemoral

glide/translation.Theseactionsareconsistent,regardlessofwhichboneismoving.

Themenisciareattachedtothetibiaandsupporttheroll-effectduringflexionandextensionascondylarglideischeckedattheanteriororposteriorledges.

Rollandglidecharacteristicsdifferspecifictoopenandclosedchainkinematics,simplifiedintermsoftheconvex/concaverule.Iftheconvexfemurrollsontheconcavetibia,rollandglideoccurinoppositedirections;

whentheconcavetibiarollsontheconvexfemur,rollandglideshareacommondirection.

ExampleofConcave/ConvexKinematicsduringFlexion

Internal/ExternalRotation–Spin

Themovingbonerotatesinternallyorexternallyduringrollandglide.Thefemurmovingonafixedtibiarotatesinternallyduringextensionandexternallyinflexion,andthetibiamovingonafixedfemurrotatesexternally

duringextensionandinternallyinflexion.

Spinisprimarilyanimposedfunctionofbonyfactorsincludingthevariabilityinsize,articularsurfaceareaand

curvatureofthefemoralandtibialcondyles.

Themedialcondylecurveslaterallybetween25-30degreeswithminimalanterior/posteriorarticulationonthetibialcondylebecauseitisconstrainedbythedeepmedialcollateralligament.Thelateralcollateralligamentprovidessignificantlylessconstraintbecauseitattachestothefibula.Thesecomponentsaretheprimaryforces

behindthe“spin”thataccompaniestibiofemoralrollandglide.

Themeniscideformaccordinglyduringtibiofemoralrotationtomaintainaconcavesurfacefortheconvexfemoralcondyles.

Pedalingincorporatesbothopenandclosedkineticchainattributes.Thefemurmovesonarelativelyfixedtibiawhenextendingduringthepower-phase,andthetibiamovesonarelativelyfixedfemurwhenflexinginthe

recoveryphase.

Thefactthatneitherlimbisentirelyfixedwhenpedalingsuggeststhatvirtuallyallarthrokinematicmotionsoccurwithineachpedalstroke.

The primary arthrokinematics of the tibiofemoral …...Tibiofemoral Arthrokinematics The primary...

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