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ELSEVIER

Analytical
behaviors

study on the kinematic


of a knee joint

Zhi-Kui Ling, Hu-tJrng

Department
Technological
Received

and dynamic

Guo and Stacey Boersma

of Mechanical
Engineering
and Engineering
University,
Houghton,
MI 49931, USA

1 September

Med. Erg. Phys. Vol. 19. No. 1. pp. 29-36. 1997


0 1997 Elsetier Science Ltd for IPEMB. All rights resewed
Printed in Great Britain
1350-4533/97
$17.00 + 0.00

1995, accepted

10 May

Mechanics,

Michigan

1996

ABSTFUCT
A knee model in the sag&al plane is established
in this Jtudy. Specafically,
the model is used to study the e&s
of
inertia, articular
surfaces of the knee joint, and patella on the behaviors
of a knee joint.
These behaviors
includt
the
joint surfnce contact point, ligament f&-es,
instantaneous
center and slide/roll
ratio between the femur
and tibia.
Model results are compawd
to experimental
cadaver studie.5 available
in the literature,
as well as between the quasi.statir and dynamic
mod&.
We found
that inertia increases the sliding ten&ncy
in the latter part of pexion,,
and
lengthens the rruciate
ligaments.
Decreasing
the curvature
of the femur surface geometry tends to reduce the ligament
forcps and moves the contact points towards the anterior
positions.
The introduction
of the patellar
ligament
in the
model seems to stabilize the behaviors
of the knee joint as reflected by the behavior
the instant
centers and the
of the external
load
contact point pattern
on the tibia surface. Furthermore,
we ,found
that diff, Prent magnitudes
applied to the tibia do not alter the qualitative
behaviors
of the knee joint. 0 1997 Elsevim Science for IPEfiiB.
,411
right,\ re.seroed.

qf

Keywords:

Knee

Med.

Phys.,

Eng.

kinematics,
1997,

Vol.

knee

dynamics,

knee

A well-defined
analytical knee model can be an
effective tool for understanding
the functionality
of the largest musculoskeletal
joint in the human
body. Statistics show that over two million
cases ofknee injury occur in the United States each year.
This model can provide a scientific explanation
as
to the causes of these injuries. Therefore,
preventive measure can be taken to avoid them. Furthermore, a well-developed
analytical
model
could
also be used efficiently to determine
the effects of
system variables on the performance
of the knee
joint,
and to guide experimental
and clinical
investigations.
However, a comprehensive
knee
model does not exist in the literature.
Analytical knee models have generally adapted
a four bar linkage methodology,
by grounding
either the tibia or femurlm4. In these models, the
two cruciates are assumed rigid links with neutral
ligament
fibers staying constant lengths during
flexion or extension.
Furthermore,
the articular
surfaces of the femur and tibia are either simplified, or their effects are ignored
completely.
Although
these models
have provided
initial
understanding
of the knee kinematics,
they can-

to: Zhi-Kui

Ling.

geometric

modeling

19, ?9-36,January

1. INTRODUCTION

Correspondence

modeling,

not accurately portray the actual kinematic


and
dynamic characteristics
of a knee.
a quasi-static
Other studies 5- 8 have adapted
approach
towards the modeling
of a knee.
Although
the quasi-static models compensate
for
the deficiencies
of the four bar linkage model by
allowing the cruciate ligaments
to change their
lengths, they still cannot take into account the
roles of inertia
and other ligaments
in the
behavior of a knee.
To consider the effects of inertia, three studies
have attempted
to establish the dynamic model
of a knee. The first9 proposed a two-dimensional
dynamic model of a tibiofemoral
joint. The model
was used to study the contact conditions
between
the femur and tibia as well as the characteristics
of the ligament forces. The second study investigated the role of ligaments and muscles as control
elements
for a prespecified
rolling
and slidin
pattern.
Recently,
Abdel-Rahman
and Hefzy I?
presented
a dynamic model which incorporates
additional
ligament
constraints
between
the
femur and tibia to the model by Moeinzadeh
in
describing
the tibiofemoral
joint.
However, the
entire articular surface of the femur was assumed
to be a circular arc. The contact point positions
and forces between the femur and tibia and the
ligament
forces were studied.
The
existing
dynamic models do provide further understand-

Analytical

study on the behaviors

of a knee joint:

Zhi-Kui

Ling et al.

ings of a knee joint.


However, deficiencies
still
exist. Specifically,
the role of the patella in the
behavior of a knee joint is usually considered separately 12*13 Furthermore,
the techniques for calculating the loci of instant centers and the roll/slide
ratio during knee motion are absent in the existing models. However, these are important
factors
in studying the kinematics
of a knee. Furthermore, the effects of the joint surface geometry on
the behaviors of the knee have not been carried
out in the literature
quantitatively.
Finally, the
role of inertia in the overall behavior of the knee
is still not quite clear.
The aim of this study is to address the abovementioned
three issues in the existing twodimensional analytical knee models. Specifically,
a two
dimensional
model shown in Figure I is introduced. Formulation
for both the quasi-static and
dynamic
models of a knee is carried out. The
implicit
Euler and Newton-Raphsons
numerical
schemes are used to solve the established
equations
of motion
and
nonlinear
equations.
Methods to determine
the loci of the instant centers and roll/slide
ratio are introduced.
In
addition,
the effect of the different articular surface geometry of the femur on the behavior of the
knee is also investigated.
Results of the quasi-static model provide the
initial values for the simulation
of the dynamic
model. Although
no experiments
are performed
in this study, results from the analytical model are
compared with the available experimental
data in
the literature.
These results include the ligament
forces, the contact conditions,
the loci of the
instant centers, and the rolling/sliding
behavior
between the femur and tibia.
The remainder
of this paper is organized into
four sections. First of all, the analytical model and
its numerical
solution
are introduced.
Secondly,
methodologies
used to determine
the iristant centers and slide/roll
ratio are described. Results and
discussions are presented next, followed by a conclusion.

2. ANALYTICAL

Because the fibula does not make contact at the


articulating
surface of the tibiofemoral
joint, its
effects are ignored in this study. The contours of
both the femur and the tibia in the sagittal plane
are acquired using the radiographs
of a left, unattached leg of a 6%year-old female cadaver, with
carcinoma
reported
as the cause of death. The
radiograph
conditions
include an unloaded
leg,
horizontally
positioned
with the lateral side down.
Reference axes for the model are set up with
the Y axes centred along the bones longitudinal
axes, pointed towards the knee joint contact surfaces, as shown in Figure 1. In this study, the profile of the femur is described with two segments,
as shown in equations
(1) and (2). This reflects
the actual shape of the femur14. A second-order
polynomial
in equation
(3) is also generated
to
describe the two-dimensional
profile of the tibia
in the sa ttal plane. The maximum
fit errors of
1.8 x10- P and 4.497 ~10~~ cm are found for the
two contours of the femur and the tibia, respectively. The three profiles are as follows:
~~(x_=04b0110~~~4637x-0.13492
fib(x) = 2.733 + &8144-(x
f&d)

30

A knee

+ 2.692)2
+ 0.0477~

(2)

(3)
Five major ligaments
are represented
in the
model. They are the medial collateral
(MCL) , lateral collateral (LCL) , anterior cruciate (ACL) , the
posterior
cruciate (PCL), and the patellar ligament. Both the ACL and the PCL are represented
by their anterior and posterior bundles. Their twodimensional
insertion
and origin
points
are
obtained from the literature5,
and listed in Table
1. These numbers have been adjusted to the coordinate systems discussed before.
In the following discussion, formulation
of the
analytical
model is divided
into two cases, the
quasi-static model and the dynamic model. Two
constraint
equations exist for both models. First,
the tibia surface must be in contact with the femur
surface at one point.

F3 = ACL (mhrior)
Force
F4 = PCL Qmaior)
Force
FS = ACUposterlar)
Force
F6 = PCL (~tcrtor) Force
F7 = htdlr
L@nent
Force
Fext = Externd Force
Mext = Extend
Moment

Where, x, y0 is the origin location of the tibia


with respect to the femur, fmxc and fmyc, tibxc
and tibyc are the femur and tibia contact points,
respectively.
The second constraint
requires colinearity
of
Table

(1)

Fixed Femur Fz = McL Force

Pa:

Fii

= 21.34-0.2578x

- 0.0332

N = Normal Force
Fl = LCL Force

I -t

MODELS

i $-

model

Moving Tibia

in its sagittal

plane

Ligament

insertion

Ligament

Tibia

LCL
MCL
ACL (anterior)
ACL (posterior)
PCL (posterior)
PCL (anterior)

3.849
2.149
0.849
1.149
3.849
3.849

and origin
X

Tibia
17.579
16.079
21.079
21.079
20.579
20.579

coordinates
Y

Femur
-2.5
-2.3
-2.3
-1.9
-3.2
-1.2

(cm)
X

Femur
1.9
1.4
1.9
1.9
2.4
2.4

Analytical

Table

Ligament

k, (kg cm-

LCL
MCL
ACL
ACL
PCL
PCL

150
150
200
100
175
175

(anterior)
(posterior)
(anterior)
(posterior)

on t/w behaviors

of a knee joint:

Zhi-Kui

Ling

et al.

the knee capsular provides negligible


resistance,
a zero coefficient of friction is assumed, resulting
in only a normal force component.
The tibia is governed
by three equations
of
motion,
as shown below. In this study, the tibia
mass is estimated
at 3.45 kg, the mass for a 50
percentile malel, and the mass moment of inertia
is set to be 392.8 kg cm2.

Stiffnesses

Ligament

study

SK*)

000
000
000
000
000
000

the unit normals at the respective contact points


on both the femur and tibia. This can be represented by the zero cross product of the two normals. The simplified
form of this condition
is
shown below.

muss

= (F,.),

+ W + A(nm)

(9)

(%)y

(5)

In this study, the nonlinearity


of ligament forces
for the cruciate and collateral
ligaments
is modeled with the following expression.

smagi=

kj( how,-

Istart,) * if howi

&art,)

if< lnOWj5

hart,)

(6)

Here, j is an index number representing


different ligament.
The stiffness of the collateral
and
cruciate ligaments,
kj, are taken from the literature.16, and are listed in Table 2, and lnow is the
current length of a ligament.
In equation
(6), hart,
the taut length of the
ligament j, is calculated by multiplying
the initial
length at full extension
of the ligament
by its
strain ratio5. This is shown in equation
( { ), and
the strain ratios of the corresponding
ligaments
are shown in Table 3.
Istart, = linitial?q

(7)

In this study, the patellar ligament


is assumed
to be in the sagittal plane during flexionl.
The
magnitude
of the pate110 ligament
force is
obtained
through the ratio between patellar ligament force and quadriceps
force versus flexion
angle . The insertion
point of the patellar ligament on the tibia is specified at (-0.251,
17.779)
with respect to the tibia coordinate
system. The
angular orientation
of the patellar ligament
is referenced from the literature*.
Besides ligament
forces, a force at the contact
point exists. Because the synovial fluid present in
Table

Ligament

strain

ratio

Ligament

Strain

LCL
MCL
ACL
ACL
PCL
PCL

1.02
1.02
1.05
1.035
1.05
1.05

(anterior)
(posterior)
(anterior)
(posterior)

ratio

X[fmq$+

fma&l

where Norm is the magnitude


of the normal contact force, and A can be either positive or negative
depending
on the curvature.
In this study, the quasi-static model constitutes
equations
(l-7),
and equations
(8-10) with the
left hand sides equal to zero. The dynamic model
consists of equations
(l-10).
For the quasi-static
model, Newton-Raphsons
method is used to solve
for the six nonlinear
equations, i.e. equations
(S10) with zero accelerations,
and equations (4) and
(5). The independent
variable in these six equations is the flexion angle, and the six unknowns
are the tibia mass center (3~0, y,J, contact point
with respect to the femur and tibia (femxc, tibxc),
the normal force (nomn), and the required external moment
(K,,).
The solutions starting from
0 with 10 increment
up to 90 are calculated.
The solution at each of these positions is found,
if the tolerance is smaller than 0.0001.
For the dynamic model, there are also six equations: the three equations
of motion,
equations
(S-10)) and three algebraic constraints, equations
(4) and (5). Smce the six equations are a mix of
nonlinear
and differential
equations,
this study
uses both
the implicit
Euler
and NewtonRaphsons in simulating
the dynamic model. The
advantage of implicit Euler is its stability, however,
the method only provides a first order accuracy.
Iterations
are performed
at each time step until
convergence
occurs. In this study, the time
increment
for the implicit
Euler method is set at
0.0001 s. The solution for each time step is achieved if the tolerance of 0.0001 is achieved.

31

Analytical

study on the behaviors

2.1. Instant

of a knee joint:

centers and slide/roll

Zki-Kui

Ling et al.

ratio

The instantaneous
centers of rotation for both the
quasi-static
and dynamic
models are found by
using the instantaneous
velocities of two points on
the moving tibia. They are the tibia contact point
and the tibia mass center. For the quasi-static
model, the line representing
the velocity at the
tibia contact point is approximated
by the line
connection
between the contact point, and the
same contact point at its next position. The same
technique
is used to determine
the velocity line
at the mass center of the tibia. The instant center
is then determined
by constructing
two perpendicular lines to the two velocity lines at the contact
point and the mass center. The intersection
point
of the two perpendicular
lines is the instant center
location at that particular
instance.
For the dynamic model, the velocity at the mass
center of the tibia is known from model simulation. However, the velocity at the contact point
is unknown. In this study, the x and y components
of the
contact
point
velocity,
(dXtitml/&
df2( tibxc,)/dt),
are found by using the contact
point and the same point at the next time step.
A first order forward difference
approximation
scheme is used in the determination
of the contact point velocity. The same two perpendicular
lines to the velocities at the mass center of the
tibia and the contact point are constructed
to
determine
the corresponding
instant centers.
To calculate the slide/roll
ratio, the arc lengths
travelled on the surfaces of the tibia and femur
between two consecutive
simulation
times are
determined
with the following
numerical
integration.

(11)
For either contour surface (fi or f2), the lower and
upper limits are the X components
of two adjacent contact points. The slide/roll
ratio is defined
as the difference. between the larger distance (D)
and the smaller distance (d) travelled
on the
femur and tibia over the smaller of the two arc
lengths travelled (d) .
3. RESULTS

AND

Profun -Pnnnoz.--Plww3 - . . .. . .
KiMllUllO.0
I

x
-3.5 -4-

Figure

Femur

contact

points

radius of the circular


arc in equation
(2) is
reduced by 0.1 cm and 0.22 cm, respectively. The
original and the two new profiles of the femur are
identified
as profile 1, 2 and 3 hereafter. Finally,
the effect of the patella on the knee behavior is
also studied with the model.
A constant impulse force with a magnitude
of
20 N is applied along the x axis of the tibia with
a duration
of 0.1 ..s in the analytical
model.
Although
the effect of different external loads on
the behavior of the knee is not the focus of this
study, a qualitative
study is performed.
In the
remainder
of this section, the results of the aforementioned
studies are presented.
The contact point with respect to the femur and
tibia travels posteriorly
with flexion as shown in
Figures 2 and 3. This is in aFeement
with the
results reported by othersgs, . In Figure 2 it can
be observed that as the curvature of the femur
surface profile becomes smaller, contact points
shift towards the anterior
direction.
The inertia
has a greater
impact
on the contact
point
behavior
towards the latter part of the knee
flexion. From Figure 2, it is also shown that the
transition
from the first to the second profile of
the femur is not perfectly smooth. This is due to
the fact that the slope at the connection
point of

DISCUSSIONS

The already-established
analytical models are used
to provide a comparison
between the kinematic
and dynamic
results in terms of the following
characteristics:
the contact points on the femur
and tibia; the ligament
forces; the instant center
locations; the slide/roll
ratio, all with respect to
the flexion angle.
The effects of the articular surface geometry on
the dynamic behavior of a knee are also investigated. This is accomplished
with the reduction
of
the curvatures of the femur surface. Specifically,
the coefficient for the linear term, 0.4637, of the
first femur profile in equation
(1) is reduced to
0.4137 and 0.3637, respectively. The second profile of the femur is also changed. In this case, the

Figure

10

Tibia

contact

30

points

40
50
Flaxion Dqrn

60

70

30

so

Analytical

the two profiles is not completely


continuous
in
the modeling
of the femur contour. The rest of
the results are also affected by this phenomenon.
In Figure 3, the contact point with respect to the
tibia travels posteriorly
as well with flexion. However, the contact point moves in a faster rate
towards the posterior direction
for the dynamic
model than for the kinematic
model as flexion
exceeds 40. The effect of the patellar ligament
on the contact point pattern of both the femur
and tibia is barely noticeable.
Ligament
forces in both LCL and MCL exhibit
maximum
magnitudes
at the full extension position. As flexion starts, the ligament forces start to
decrease and are faded to zero before the full
flexion of 90 is reached. It is found that the effect
of inertia on the collateral ligaments is not apparent. Furthermore,
the ligament
forces abate as the
curvature of the femur surface decreases. Introduction of the patella in this study does not make
any difference
in the behavior of the MCL, but
stretches the LCL ligaments.
This is shown in Figure 4.

It may not be appropriate


to compare
the
results of the ligament
forces from the analytical
models with those of experiments
quantitatively,
since different boundary conditions
were used in
those experiments
and the analytical studies. Furthermore,
different opinions exist with regard to
the functions of ligaments20-24. Finally, most of the
experimental
studies are quasi-static
in nature.
Therefore,
the discussion here on the ligament
forces is confined to qualitative
comparison.
For
the collateral ligaments, the results from this study
using both the quasi-static and dynamic models
qualitatively
agree with those found in the exyerimental studies. The experimental
results21.2 ,24.L5
indicated
that from full extension,
the collateral
ligament
forces have the maximum
values, and
decrease as the knee flexes.
While the ligament
force of the anterior PCL
increases and then decreases with respect to the
flexion
angle, the force in the posterior
PCL
decreases very rapidly, as shown in Figure 5. Furthermore,
while the force in the anterior fiber of
the PCL from the dynamic model is larger than
300
I

250

\
h \

MCL with Pateliar ligament

I\

200

MCL without PaWar

LCL wkh Paldlar

liint

LCL withoul Patek

=-

ligament

=.-.-.(

=
tiit

=+
1

T+
0

+++&
0

Figure4
collateral

10

h~fluence
ligaments

20

30

40
50
Ftexion Degree

of the patellar

ligament

M)

over

70

80

the forces

90

in the

Figure
antrrior

study on the behaviors

of a knee joint:

The behaviours
of the PCI. ligament
and posterior
bundles

%hi-Kui

force

Ling et al.

iu terms

of in

that from the quasi-static model during the early


part of flexion, the trend reverses after flexion
angle passes 42.
As the curvature of the femur declines, the ligament forces in both fibers of the PCL decrease.
While the patellar ligament
has no effect on the
posterior fiber of the PCL, it stretches the anterior
fiber of the PCL in the early part of the flexion,
and provides relief for the fiber in the later part
of the flexion. From the modeling
standpoint,
this
can be explained
with the fact that the posterior
fiber is used to provide the moment
to balance
that produced by the patellar ligament in the early
part of flexion.
The analytical
results of the PCL match with
those from experiments22.
The difference exists in
the anterior fiber, where the maximum
ligament
force occurs during the early part of flexion in the
analytical modeling.
However, the overall trend of
the ligament
forces follows the experimental
results. The effect of inertia on the posterior fiber
of PCL is difficult to observe, since the ligament
force becomes zero before 10 of flexion. The
small value of posterior PCL force was also indicated by others 26,2. The anterior portion of PCL
exhibits a decrease in the ligament force when the
inertia force is considered
in the later part of
flexion. This is probably due to the fact that the
inertia force acts along the same direction
as the
ligament force in the anterior PCL during flexion
of the knee.
While the ligament
force of the posterior ACL
increases with respect to the flexion angle, force
in the anterior ACL decreases and then increases
for the dynamic model. Yet, while the posterior
ACL increases and then decreases with respect to
the flexion angle, the anterior ACL decreases in
the kinematic
model. They are shown in Figure 6.
The difference
between
the kinematic
and
dynamic model is due to the presence of the inertia, which changes the contact pattern on both
the femur and tibia as discussed in the previous
section. Consequently,
the insertion
point of the
ACL on tibia changes its pattern of motion at the
later stage of flexion, which causes itself to be
stretched in the process. As the curvature of the

33

Analytical

on the behaviors

o?aknee joint:

Zhi-Kui

Ling et al.

350,

ACL(a)

Profile

ACL(a)

Profile

Profile

ACL(a)

250

ACL(a)

Kinematic

ACL(p)

Profile

ACL(p)

Profile

Profile

ACL(p)
.ACL(p)

it 1

Kinematic

20

30

40
Flexion

Figure

The behaviours

of the ACL

ligament

force

in terms

of its anterior

femur decreases, the ligament


forces in both fibers of the ACL decrease.
While the patellar ligament
has little effect on
the pattern of the ligament
forces in either fiber
of the ACL, the forces in ACL increase as flexion
increases. From the modeling
standpoint,
this can
be explained
with the fact that the ACL is used
to provide the moment
to balance that produced
by the patellar
ligament
in the later part of
flexion. For the anterior cruciate ligament,
results
from the analytical model without the patella do
match with those from experiments,
such as
France et a~!. The ligament
force in the anterior
portion
of the ACL decreases from 0 to 90 of
flexion, while the posterior portion increases from
0 to 50 and then decreases towards the 90
flexion.
The instantaneous
centers obtained
from the
quasi-static model follow a circular path, beginning at around 20 of flexion anteriorly
on the
proximal
femoral condyle, and ending at 90 posteriorly closer to the joint
surface also on the
proximal
femoral
condyle. When the inertia is
considered,
the instantaneous
centers have the
same pattern as demonstrated
by the quasi-static
model, nevertheless, they are located in the posterior side of the instant centers from the kinematic model. The effect of changing
the surface
geometry of the femur on the instant centers is
minimal.
However,
the instant
centers
shift
anteriorly as the curvature of the femur decreases.
Patellar ligament
constraint
makes a big difference in the locus of the instant centers for the
dynamic model. Figure 7 demonstrates
this difference where the model without the patella locates
the instant centers in the tibia side of the joint at
the higher degrees of flexion, while the instant
centers of the model with the patella are located
on the femur side.
The loci of the instant centers from experimental studies are only available with the quasistatic approach. These instant centers were found
using X-rays at incremental
degrees of rotation**.
Therefore,
comparison
between the results from

34

50

60

70

60

90

Degree

and posterior

bundle

x am

Figure
instant

7 Influence
centres

of the patellar

(al)

ligament

over

the loci

of the

this study and the experimental


results may not
be appropriate,
as the methods used to determine
each individual
instant center are different. However, for the quasi-static
model,
the analytical
results display the trend of the instant center locus
which is similar to the experimental
results.
It can be concluded
that rolling is dominant
at
the beginning
of flexion, and sliding becomes the
dominant
factor as the flexion increases. There is
very little difference between the slide/roll
ratio
of the quasi-static and the dynamic model during
flexion from 0 to 60. However, the ratio dips
lower for the quasi-static model when the flexion
angle exceeds 60. The change of femur curvature
has very little effect on the slide/roll
ratio. Furthermore,
the patellar
ligament
facilitates
the
increase of rolling
in the latter part of knee
flexion, as illustrated
in Figure 8. Although
there
are no experimental
results
available,
the
slide/roll
ratio obtained from this study matches
with the consensus as related to the attern of sliding versus rolling in the literature r .
Although
no graphs are presented in this paper
to illustrate the behaviors of the knee joint under

Amlytiral
5
with patekr

ligament = -

4.5 without pstellar

liQa"Mt

= - - -

/
,

4-

3.5

,
!

1Slii<Rcdl

0.5

Or
0

Figure
ratio

10

20

Influenc?

34

of the

40
50
Flexion Degree

patellar

ligament

70

60

over

80

90

the Slide/Roll

The following conclusions can be made from the


results obtained in this study. (a) Since a majority
of the knee models and the experimental
studies
in the literature
are kinematic
and quasi-static in
nature, the results from the kinematic
model are
found to be validated
more easily with cadaver
studies, as compared
to the dynamic model. (b)
The ligament
force pattern from the analytical
study matches very well with the experimental
result, especially
that of France et aZ.*. The
smaller curvature of the femur tends to reduce
the magnitudes
of the ligament
forces. Furthermore, the inertia force does have different effects
on the behavior
of various
ligament
forces.
Finally, the patellar ligament
in general does not
have a significant effect on the ligament characteristics discussed in this paper, except in the case of
ACL. (c) A relationship
is found to exist between
the highest ligament
force and the tibia contact
point. III general, the maximum
ligament
force
pulls the two bones together, causing the contact
point to shift in the direction
of the force. This
can also be attributed
to soft tissue imbalance
caused by the surface geometry of the knee joint
as discussed by Attfield et al. (d) In general, loci
of the instantaneous
centers from both the quasistatic and dynamic models follow the pattern indicated by the quasi-static studies from the experiment. Smaller femur surface curvature causes the
movement
of instant centers in the anterior direction. Yet, the patellar ligament makes a difference
in the relative locus of the instant centers for the
dynamic simulation,
where without the consideration of the patella, the locus is located on the
tibia side for the higher degrees of flexion.
(e)
The pattern of the slide/roll
ratio conforms with
the conclusion in the literature.
Changing the cur-

on thr behavim

of n knee joint:

Zhi-Kui

Ling

et al.

vature of the articular surfaces of the femur has


little effect on the ratio, while the inertia does
increase the rolling factor a small amount in the
later part of the knee flexion. The patellar ligament also contributes
to the larger rolling/slide
ratio during the later part of knee flexion. (f) Different magnitudes
of the external load have little
impact on the behavior pattern of the characteristics discussed in this study. (g) Based on the
the following
recommenabove conclusions,
dations can be made to the prosthesis designers.
Smaller prostheses may be preferred. A well constructed patella is critical in the normal function
of a knee after total reconstruction.
The results of the study presented
here have
provided
a foundation
for a three-dimensional
study, which is being pursued by the authors.
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different
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change in the patterns of
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4. CONCLUSIONS

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