The ability to quantify kinematic parameters of the knee is crucial in understanding normal biomechanics, recognising the presence of pathology and its severity, planning treatment and evaluation of outcomes. Current methods of quantifying lower limb kinematics remain limited in allowing accurate dynamic assessment. Computer assisted surgery systems have been validated in quantifying kinematic parameters, but remain limited to the operative setting. Recently, image-free computer assisted surgery technology has been adapted for non-invasive use and validated in terms of repeatability in measuring coronal and sagittal femorotibial mechanical alignment in extension. The aim of this thesis was to develop and implement a set of validation protocols to quantify the reliability, precision and accuracy of this non-invasive technology in quantifying lower limb coronal and sagittal femorotibial mechanical alignment, anteroposterior and rotatory laxity of the knee by comparison with a validated, commercially available image-free computer assisted surgery system. Pilot study confirmed feasibility of further experimental work and revealed that the noninvasive method measured with satisfactory precision and accuracy: coronal mechanical femorotibial alignment (MFTA) from extension to 30° knee flexion, anteroposterior translation in extension and tibial rotatory laxity during flexion. Further experiments using 12 fresh cadaveric limbs revealed that the non-invasive method gave satisfactory precision and agreement with the invasive system measuring MFTA without stress from extension to 40° knee flexion, and with 15Nm coronal stress from extension to 30° knee flexion. Using 100N of anterior force on the tibia, the non-invasive system was acceptably precise and accurate in measuring sagittal tibial displacement from extension to 40° flexion. End of range apprehension, such as has been proven repeatable in measuring tibial rotatory laxity was used and the non-invasive method gave superior 3 precision and accuracy to most reported non-invasive devices in quantifying tibial rotatory range of motion. Non-invasive optical tracking systems provide a means to quantify important kinematic parameters in health and disease, and could allow standardisation of knee examination increasing communicability and translation of findings from the out-patient to operative setting. This technology therefore could allow restoration of individual specific kinematics in knee arthroplasty and soft-tissue reconstruction.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:646750 |
| Date | January 2015 |
| Creators | Russell, David F. |
| Publisher | University of Glasgow |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://theses.gla.ac.uk/6300/ |
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