An anatomy-based coordinate system for the description of the kinematic displacements in the human knee

The effects and interaction of the anatomical displacements in the human knee are a prerequisite to an accurate assessment and communication of the kinematic data. For the kinematic information to be used to improve diagnosis and treatment, and for better prosthetic design and installation, there must be clear, concise, and universal definitions of the displacements. In general, the displacements are defined as three translations and three rotations. In this paper, anatomic landmarks on the femur and on the tibia are used to define the locations and orientations of the six displacement axes; i.e. three translational and three rotational displacement axes. The most commonly accepted kinematic representation of the knee joint, in the literature, is a special geometry three-cylindric open chain in which the axes of the cylindric joints are defined according to the rotational displacement axes. The sequentially adjacent joint axes are assumed to not only intersect but to intersect at right-angles. The open chain permits a total of six degrees of freedom between a Cartesian reference frame attached to the femur and a Cartesian reference frame attached to the tibia. In this paper, the three rotational axes are shown to be skewed and off-set from each other, therefore, a three-cylindric open chain with skewed joint axes is proposed to measure the six displacements between the two reference frames. The authors believe that the proposed open chain is the most general to date and provides a more realistic representation of the displacements in the knee. To illustrate the significance of the reference frames on the interpretation of measured data, the anterior/posterior drawer is plotted against per cent gait cycle for three existing open chains and the proposed open chain.