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Cited by 34Knee injuries and reconstruction techniquesTotal Knee Arthroplasty OutcomesLower Extremity Biomechanics and Pathologies

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The clinical epicondylar axis is not the functional flexion axis of the human knee

Mochizuki, Tomoharu, Sato, Takashi, Watanabe, Satoshi, Koga, Yoshio, Blaha, John David, Tanifuji, Osamu, Yamagiwa, Hiroshi, Endo, Naoto, Kobayashi, Koichi, Omori, Go·2014·Journal of Orthopaedic Science
DOI 10.1007/s00776-014-0536-0
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Abstract

Background The functional flexion axis (FFA) is the principal axis around which the knee moves and thus, by definition, does not move in vertical displacement relative to the tibia. The transepicondylar axis (TEA) has been reported to coincide with the FFA. If that is not true, the TEA should show vertical displacement during motion, and this hypothesis was investigated. Methods Three-dimensional knee kinematics of 20 healthy volunteers were determined during a squatting motion via a 3-dimensional to 2-dimensional image registration technique by calculating the vertical displacement of the clinical epicondylar axis (CEA) through the full range of motion. Results From 0° to 90° knee flexion, the average vertical displacement of the lateral end of the CEA was <3 mm, whereas that of the medial end was large (7.6 mm). Discussion The large vertical displacement of the medial end of the CEA suggests that the CEA is not the FFA. This finding implies that the CEA may not be an appropriate axis for a TKA prosthesis having a "single radius" design. Evidence level Level IV.

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Research works printed but not linked: 25

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Metadata

Authors
Mochizuki, T., Sato, T., Watanabe, S., Koga, Y., Blaha, J. D., Tanifuji, O., Yamagiwa, H., Endo, N., Kobayashi, K., & Omori, G.
Affiliations
  • University of Michigan (US)
  • Niigata Medical Center (JP)
  • Niigata University (JP)
Corresponding author
Mochizuki, Tomoharu
ORCID
Venue
Journal of Orthopaedic Science
Publisher
Elsevier BV
Published
2014-05
Volume
19
Issue
3
Pages
451-456
ISSN
0949-2658 (ISSN-L)
DOI
10.1007/s00776-014-0536-0
OpenAlex
W1990475800
Cited by
34
References
0
Citations by year
2025: 2 · 2023: 3 · 2022: 2 · 2021: 8 · 2020: 3 · 2019: 4 · 2018: 5 · 2017: 2 · 2016: 1 · 2015: 3 · 2014: 1
FWCI
2.31
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Orthopaedic Science (publishedVersion)
  • PubMed (publishedVersion)
Funders
Japan Society for the Promotion of Science (24246025)
Topics
  • Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
  • Health Sciences › Medicine › Surgery › Total Knee Arthroplasty Outcomes
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
Keywords
transepicondylar axis, knee kinematics, squatting motion, vertical displacement, total knee arthroplasty
MeSH terms
Adult, Algorithms, Biomechanical Phenomena, Female, Humans, Knee Joint, Male, Middle Aged, Reference Values, Tomography, X-Ray Computed, Range of Motion, Articular, Imaging, Three-Dimensional

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