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An Experimental Model for Kinematic Analysis of the Knee
Jan Victor, MD, PhD1; Francis Van Glabbeek, MD, PhD2; Jos Vander Sloten, Ir, PhD3; Paul M. Parizel, MD, PhD2; Johan Somville, MD, Ir, PhD2; Johan Bellemans, MD, PhD4
1 Department of Orthopedics, AZ St-Lucas, St-Lucaslaan, 8310 Brugge, Belgium. E-mail address: j.victor@skynet.be
2 Departments of Orthopedics (F.V.G. and J.S.) and Radiology (P.M.P.), Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium
3 Department of Mechanical Engineering, Catholic University Leuven, Celestijnenlaan 300c – bus 02419, 3001 Heverlee, Belgium
4 Department of Orthopedics, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
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Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from Smith and Nephew and Sanofi Aventis. In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Smith and Nephew).

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Nov 01;91(Supplement 6):150-163. doi: 10.2106/JBJS.I.00498
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The description of the relative motion between rigid bodies is called kinematics. The knee joint is the largest joint of the human body and has an intricate anatomy, and thus its kinematics have intrigued researchers for a long time1. Apart from direct visual observation, the most popular tool for studying the joint has been radiography. Historically, the knee has been treated as if it were a planar mechanism2. In other words, the movement of the knee was reduced to a two-dimensional projection of a three-dimensional reality. In recent years, the limitations of this methodology have become clear, with the major flaw being the inability to ascertain the location of the axes of rotation before performing kinematic analyses3. In 1983, Grood and Suntay presented a joint coordinate system that provided a geometric description of the three-dimensional rotational and translational motion between two rigid bodies, and they applied this system to the knee joint4. With use of this model, the described joint displacements became independent of the order in which the component rotations and translations occur. The new mathematical insights led to the concept of the helical axis and opened the door for a correct scientific description of the kinematics of the knee, thus allowing for six degrees of freedom5. However, as the mathematical accuracy improved, the complexity increased and the model appeared to be impractical and difficult to apply to the clinical setting (i.e., the clinicians failed to understand the engineers).
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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