Dear Subscribers, I am in the process of compiling some measurements (the knee) in order to model the joint on the ASIC, ANSYS, or IDEAS software and for the life of me, I cannot find any publically available info concerning the dimensions of the knee. Is there some type of data base, or one book with at least that might have lengths, widths, etc. of the femur, tibia and major soft tissue components? I am this close to performing surgery on myself, ruler in hand. Thanks for the help. Spencer Malcolm S.D.Malcolm@sms.ed.ac.uk University of Edinburgh-Mechanical Engineering King's Buildings-Sanderson Mayfield Rd. Edinburgh, UK EH9 1JD REPLIES: I forgot to mention that we had a paper on modeling the knee with IDEAS soft ware at the ISB last year, and would send the abstract if you are interested. AMH Anne Hollister, MD LSUMC-S / Orthopaedic Surgery 1501 Kings Hwy. Shreveport, LA 71130-3932 email: anne@www.ortho.lsumc.edu I am currently creating a knee model using Pro/Engineer software which works much like IDEAS. I am using a combination of CT scan cross sections and geometric entities. I have parameters from an unpublished study, "Dimensional and Geometric Anaysis of Human Long Bones in Asian Population" by E.Y.S. Chao and others from the Johns Hopkins University Department of Orthopeadic Surgery. Here are caucasian parameters NO GENDER (mm): Femur parameters: BL Bone length 453 mean, 405 min, 504 max HNL Head Neck Length 102, 90,119 LTw Width of Lesser Trochanter 48, 39,59 (AP view) Wsf Width of Distalfemur 84,70,97 (AP view) Tibia parameters: BL Bone length 365,310,420 Here are oriental paramters NO GENDER (mm): Femur parameters: BL Bone length 400,355, 431 HD Head Diameter 44, 38, 49 HNL Head neck length 89,79,106 Alpha 132,118,140 LTw Width of Lesser Trochanter 42,36,49 Wdf Width of distal Femur 74,63,80 Wmc Width of medial Condyle 56,47,67 Wlc Width of lateral Condyle 57,46,66 Tibia parameter: BL Bone Length 326,288,384 Wtp Width of tibial plateau 68,59,77 Htp Height of tibial plateau 14,10,21 Theta lp Lateral slope angle 60,51,69 Theta mp Medial slope angle 68,61,87 Alpha Tibial plateau-shaft angle 87,5,95 Beta Posterior slope angle 11,2,18 Gamma Tibial plateau sagital slope angle 18,9,31 Other references: REFERENCES Chao, E.Y.S., "Biomechanics Of High Tibial Osteotomy". In Evarts, C. M> (ed.): Management of Knee Disorders, St. Louis, C. V. Mosby, 1978 p143. Conventry, M. B., "Upper Tibial Osteotomy for Osteoarthritis of the Knee", J. Bone Joint Surg. 67A:1136, 1985 Erkman, M. J. and Walker, P. S. "A study of Knee geometry Applied to the design of condylar prosthesis", Biomed. Eng. 9:14 1974 Highgenboten, C. L., Jackson, A. Asschliman M. and Meske, N. B. " The estimation of femoral condyle size", Clin Orthop. 174: 96-106, 1983 Condyles of similar width have similar contours and dissimilar widthd have dissimilar contours. Variablility in the measurement of Roentgenograms. Hight and Gender are better predictors. This method would be the reverse process by which anthropoplogic researchers determine height and weight from the measurment of specific skeletal parts. Himeno, S., Chao, E. Y. S., Tsumura, H. Hsu, R. W. W., Sim, F. H. and Coventry, M. B. , "Plateau pressure distribution before and after knee osteotomy", AAOS 55th Annual Meeting, Atlanta, Georgia. Feb. 4-9, 1988 The axial alignment and distribution of plateau pressure are two biomedical factors wich could be shanged during surgery to alter the outcome of the treatment. Preoperative simulation of tibial osteotomy anc careful wedge angel selection seems to enhance clinical results. Huiske, r., Kremers, L. Lange A, Wolting H. J., Selvic, G. and Rens J. G. "Analytic sterophtogrammetric determination of three-dimensional knee joint geopmetry." J. Biomech. 18: 559-570, 1985 Hungerford, D. S., Kenna, R. V., and Krackow, K. A. "The porous-coated anatomic Total Knee ", Orthop. Clin. North Am. 13:103, 1982 "Normal knee kinematics are a complex function of surface geometry of the component parts, orientation and tension of ligaments, and applied external forces." "As flexion proceeds, the condyles roll posteriorly on their respective tibial plateaus. However there is a concomitant torsional movement known as the "screw home" movement. This rotation about the long axis of the tibia occurswith each flexion and extension . It is automatic, thst is , not a function of imparted muscle forces but a function of the anatomic shape of the tibia and femur and the ligamentous attachments. It provides greater stability in extension and relative freedom of rotation in flexion. By 40 to 50 degrees of flexion, through a combination of rolling and sliding motion the condyles have reached the posterior margins of their respective tibial plateaus. The asymmetry of the rolling sliding motion of the medial and lateral femoral condyles results in a greater posterior roll of the condyle on the lateral tibial plateau trhan on the medial side. The posterior roll averages 6mm on the medial side compared with 12mm on the lateral side . This difference results in 20 degrees of automatic rotation." Posterior slope of the tibial plateaus and the decreasing radii of curvature of the condyles, the femoral and tibial points of attachment of the medial and lateral collateral ligaents are moving closer to one another. Since the decrease in the radius of cuvature is greater for the lateral tibial plateau slopes more sharply posteriorly than the medial plateau, the lateral collateral ligament becomes more lax than the medial collateral ligament, This has important consequences in terms of elective or active rotation of the tibia relative to the femur." Paper includes torque rotation curves for the knee during flexion. Also design characteristics of the replacement. Hsu, R. W. W., Himeno, S., Coventry, M. B., Chao, E. Y. S. "Normal Axial Alignment of the Lower Extremity and Load-Bearing Distribution at the Knee" Clin Orthop. 255: 215-227, 1990 Geometry of the knee joint analyzed using a full length weight bearing roentgenogram of the lower extremity (X-Ray). "The eccentric redistribution of normal stress is induced by abnormal axial alignment. A vicious cycly may occur with continuing cartilage and subchondral bone degeneration associated with progressively abnormal axial alignment. Osteotomy is one of the surgical methods that can correct joint pathomechanics and may break down this vicious cycle. The tibial mechanical angle measured 1.2x varus. Distal Femoral anatomic valgus 4.9x Center of femoral head defined using the Mose hip template. The knee center is the midpoint of the tibial spines halfway between the intercondylar notch. Install, J. N. Joseph, D. M. and Misika, C.: High tibial osteotomy for vargus gonerarthrosis: A long -term follow-up Study: J. Bone Joint Surg. 66A:1040, 1984 Johnson. F. Leitl. S. and Waugh, W.: The assessment of loads in the knee joint. Med. Biol. Eng. 19:237, 1980 Kurosawa, H., Walker, P. S., Abe, S., Garg. A. and Hunter T., "Geometry and Motion of the Knee for Implant and Orthotic Design" J. Biomechanics 18:7, 1985 Most knee replacements anre consylar replacement types that ignor the apparent asymmetry of both the femoral and tibial condyles. Need most important contours and landmarks for sugery. "An important objective should be to resore the normal internal kinematics of the joint, so ass to achieve normal ligament length patterns, as well as normal lever arms of the muscles and of the external forces." Posterior condyles represented as spheres with medial- lateral spacing defined. Onaverage the medial radious was slightly larger than the lateral, at 21 mm and 18.6mm. Average spacing was 45.9mm Laskin, R. S., " Alignment of total knee components", Orthopedics 7:62 1984 Lotke, P. A. and Ecker, M. L."Influence of Position of prosthesis in total Knee Replacement". J. Bone Joint Surg. 59A:77, 1977 Mensch. J. S. and Amstutz, H. C. "Knee morphology as a guide to knee replacement" Clin. Orthop. 112:231, 1975 Molton, A. and Upadhyay, S. S. , "A dirct method of measuring femoral anteversion using ultrasound" JBJS, 64B, 1982 Moreland, J. R., Bassett, L. W., and Hanker, G. J, "Radiographic analysis of the axial allignment of the lower extemity", J. Bone Joint Surg. 69A:745, 1987 Morrison, J. B. "The mechanics of knee joint in relation to normal walking" J. Biomech. 3:51, 1970 Parsons, F. G., "The Characteristics of the English thigh bone" Anat. Physiol. 48:238, 1914 Pick , J. W. Stack, J. K. and Anson, B. J. " Measurements of the human femur" Lengths, diameters and angles" Quart. Bull. Northwester Univ. Med. School 15:281-290, 1941 Prodromas, C. C., Andriacchi, T. P., and Galante, J. O.,"A relationship between gait and clinical shanges fowwowing high tibial osteotomy", J. Bone Joint Surg. 67A:1188, 1985 Ruby, L., Mital, M. A. , O'Conner, J. and Petal, U., "Anteversion of the femoral neck, "Comparison of methods of measurement in Patients", JBJS, 61A, 46- 51, 1979 Seedhom, B. B., Longton, E. B., Wright, V., and Dowson, D., "Dimensions of the knee: Radiographic and autopsy study of sizes required for a knee prosthesis", Ann. Rheum. Dis. 31:54, 1972 Smith, D.K. Berquist, T. H. An, K. N. , Chao E. Y. S. "The validation of three dimensional reconstruction of knee anatomy: CT versus MRI imaging." J of Comp Ass -Hold that scalpel! You might want to take a look at the National Library of Medicine's Virtual Human project. Apparently, they have digitized entire cadavers and placed them on the Internet. The address is: http://www.nlm.nih.gov. Also, this work is outlined in the Journal of the American Medical Association (JAMA) in the following issues: 273(4): 273-275, 1995 275(4): 269-270, 1996 Hope this is helpful - good luck with your work. Sincerely, David Curd, M.S. Director of Research Hughston Sports Medicine Foundation Columbus, GA USA -Dear Mr. Malcom, I do not know a lot about it, but I suggest you to give a look to the ANSYS web page (http://www.ansys.com) under "case study". I saw there is something, with pictures, about knee. Regards, Giuseppe -While not attempting to sound redundant, factors taking in skelatal mass, failure to take in soft tissue, taking in soft tissue you must then add to your data base the entire populace of the world +1.A reliable source of Information , would be any mfg. of knee joints - Otto Bock, U.s.M.c> or Becker Orthopedics, they can break down there demensions. I am sure that they will be very informative. Tom LeTourneau C.P. , B.O.C.,O President LeTourneau Lifelike Orthotics and Prosthetics. -Hi Malcolm, You can get polygonal surfaces for the knee that were digitized from a model from a company in Orem, Utah called Viewpoint. Here is their web address: http://www.viewpoint.com/datashop/ Also, you may want to check out the web page for XYZ Scientific Applications, since they make a mesh generator that will read the viewpoint data. There are also examples there of meshes. They are at: http://www.xyzsa.com/ Enjoy, Jeff Weiss -You could start with: Erkman MJ, Walker PS: A study of knee geometry applied to the design of condylar prostheses. Med Biol Eng. 14, Jan 1974 They provide avg dimensions of 25 male and 25 female knees. The data are also summarized in Peter Walkers book: Human Joints and their artifical replacements. Charles C. Thomas 1977 Good Luck -------------------------------------------------------------------------- John A. Hipp, Ph.D. voice: (617) 667-4564 Orthopaedic Biomechanics Laboratory FAX: (617) 667-4561 Beth Israel Hospital and page: (617) 667-5555 ID 1657 Harvard Medical School email: jah@bihobl2.bih.harvard.edu 330 Brookline Ave Boston MA 02215 -------------------------------------------------------------------------- -I recently published chapter 22 entitled "Joint-articulating surface motion" in the Biomedical Engineering Handbook, Joseph D. Bronzino editor, CRC Press, Inc, 1995, which contains information you will need. Kenton Kaufman, Ph.D. Motion Analysis Laboratory Children's Hospital 3020 Children's Way San Diego, CA 92123 -You can probably find some public CT scans on the WEB. Also NIH Image is a program you can use (Public Software) to look at the scans, and figure out dimensions. Good luck. -Hi Spencer, I've just completed some fe models of the patella and have had to construct the model geometry out of MRI scanned data slices. There are models of the knee available, for instance I know SDRC (I-DEAS) may have a database containing this info, see the ICONN usr group archives. Also you can get access to the visual human proj ct at the Nation Library. However, for a complete model e.g. the inner bon distribution, I found these slice to be not of an extremely good enough quality. Aprt from that and access to the NASA model, I think, (its referenced in a paper on 3D modelling) then I'm afraid you are going to have to create one from scratch. Good Luck, You'll need it Andrew Hart Univeristy of Teesside. a.hart@tees.ac.uk -Spencer, I know NASA (National Aeronautical and Space Administration) has done some extensive studies and have developed regression equations for individual body segments. The will provide segment length, mass, and volume given race, height, weight, and age(?). These equations are public domain and I found them at the local university library. If you cannot locate them let me know and I will get the reference numbers for you, sorry I don't have them at hand. Good Luck! Dwight G. Bronson Texas Scottish Rite Hospital for Children Dallas, TX 75219 Thanks again to everyone. Spencer Malcolm S.D.Malcolm@sms.ed.ac.uk University of Edinburgh-Mechanical Engineering King's Buildings-Sanderson Mayfield Rd. Edinburgh, UK EH9 1JD
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