The effect of migration of instantaneous centre of knee orthosis rotation during gait - in vivo displacement measurements in two experimental variants.

BACKGROUND The knee joint is a bicondylar hinge two-level joint with six degrees of freedom. The location of the functional axis of flexion-extension motion is still a subject of research and discussions. During the swing phase, the femoral condyles do not have direct contact with the tibial articular surfaces and the intra-articular space narrows with increasing weight bearing. The geometry of knee movements is determined by the shape of articular surfaces. MATERIAL AND METHODS A digital recording of the gait of a healthy volunteer was analysed. In the first experimental variant, the subject was wearing a knee orthosis controlling flexion and extension with a hinge-type single-axis joint. In the second variant, the examination involved a hinge-type double-axis orthosis. Statistical analysis involved mathematically calculated values of displacement P. Scatter graphs with a fourth-order polynomial trend line with a confidence interval of 0.95 due to noise were prepared for each experimental variant. RESULTS In Variant 1, the average displacement was 15.1 mm, the number of tests was 43, standard deviation was 8.761, and the confidence interval was 2.2. The maximum value of displacement was 30.9 mm and the minimum value was 0.7 mm. In Variant 2, the average displacement was 13.4 mm, the number of tests was 44, standard deviation was 7.275, and the confidence interval was 1.8. The maximum value of displacement was 30.2 mm and the minimum value was 3.4 mm. An analysis of moving averages for both experimental variants revealed that displacement trends for both types of orthosis were compatible from the mid-stance to the mid-swing phase. CONCLUSIONS 1. The method employed in the experiment allows for determining the alignment between the axis of the knee joint and that of shin and thigh orthoses. 2. Migration of the single and double-axis orthoses during the gait cycle exceeded 3 cm. 3. During weight bearing, the double-axis orthosis was positioned more correctly. 4. The study results may be helpful in designing new hinge-type knee joints.