Numerical Simulation of Single and Double Bundle Reconstruction on Knee while Walking

This research studies behavior of ligament reconstruction on knee while walking using the integration of dynamics motion analysis and finite element analysis. The purpose is to calculate stress and strain distribution on single and double bundle reconstruction while walking. First, ligament reconstruction is tested to obtain mechanical properties, which are used for finite element analysis. Next, 3D CAD model and finite element model are constructed. Dynamics motion analysis of femur and tibia while walking is introduced. The degrees of hip and knee motion with respect to time are resulted of dynamics analysis and set as load for finite element analysis. The stress and strain on knee’s ligament reconstruction while walking are calculated by finite element method. The maximum stress and strain occur on a top of ligament while extend leg are 33.86 MPa and 0.153 mm/mm, respectively, for single hamstring bundle. The maximum stress is 43.82 MPa and maximum strain is 0.188 mm/mm for double hamstring bundles. The advantage is to understand the biomechanics of the knee ligament reconstruction while walking. This research result can help patients who have tear problem of an Anterior Cruciate Ligaments (ACL) or stroke rehabilitation and be developed for further research about force and behaviors of the other ligament and muscle in body

Prophylaxis for preventing venous thromboembolism in knee arthroscopy and soft tissue reconstruction: consensus statements from an international panel of experts

Purpose There is a lack of consensus regarding need for Venous Thrombo Embolism (VTE) prophylaxis following arthroscopic knee surgery and open soft tissue knee reconstruction. Clear cut guidelines like ones for trauma surgery and arthroplasty do not exist and the published literature is limited to case reports with a few society guidelines. Given this lack of consensus, we conducted a modified Delphi questionnaire of international experts to provide recommendations on this topic. Methods The consensus statements were generated using an anonymised 3 round modified Delphi questionnaire, sent to an international panel of 38 knee surgeons, with an 80% agreement being set as the limit for consensus. The responses were analysed using descriptive statistics with measures like mode, median and box plots. Feedback was provided to all panelists based on responses from the previous rounds to help generate the consensus. Results Six consensus statements were generated after the three rounds of Delphi. Patient factors, prolonged surgery duration and family history of thrombogenic events emerged as the main points to be taken into consideration for prophylaxis. Conclusion It was established through this study, that there exists a select group of patients undergoing arthroscopic surgery that justify the usage of VTE prophylaxis. The expert responses to most of the questions in different scenarios favoured usage of VTE prophylaxis based on patient factors like advanced age, past history of VTE, smoking, oral contraceptive use etc