Three-dimensional knee analyzer validation by simple fluoroscopic study

Introduction: The complexity of the knee articulation makes its clinical evaluation extremely difficult. Insufficiency of existing instruments for knee evaluation prevents physicians from providing a diagnosis of injury and/or an evaluation of different treatments. To this end, our research group has developed a functional knee analyzer, which allows a three-dimensional evaluation of the knee in motion. The goal of this study is to scientifically validate the functional knee analyzer before using it in clinical setting. Materials and methods: The three-dimensional knee analyzer includes an orthoplastic exoskeleton attachment system, a kinematic tracking device, a screen for graphical display and a C++ program with a user interface for calculating kinematic indices. A fluoroscopic study was performed on five healthy subjects with a mean age of 28. The experiment was set-up to determine the reduction of skin movement with respect to the underlying bone by using a knee exoskeleton attachment system. The root mean square (RMS) errors of markers movement about the abduction-X (RMSRx) and tibial rotation-Z (RMSRz) axes and displacement in the XZ plane (RMSpxpz) were calculated, once by placing markers directly on the skin and once on the exoskeleton attachment system. Results: Our results demonstrated that RMSpxpz, RMSRx and RMSRz were reduced by a factor of 6 (min 1.8, max 26), 4.3 (min 0.75, max 21) and 6.2 (min 2, max 26.4) on average, respectively, for four subjects out of five when the exoskeleton attachment was used. (C) 2000 Elsevier Science B.V. All rights reserved.