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

Management of Posterior Cruciate Ligament Injuries

Background: Posterior cruciate ligament (PCL) injury is a relatively common musculoskeletal condition. However, there is currently a lack of consensus on decision-making, treatment and postoperative management for such injuries. Objectives: To use the modified Delphi method to reach expert consensus on the management of PCL injury. Methods: A literature search of PubMed, Cochrane Library, Embase, and Web of Science for articles up to 17 October 2024, to support the development of recommendation statements. An Expert Panel of 90 experienced clinicians from orthopaedics and sports medicine participated in a two-round Delphi process. Each statement was evaluated in two parts: the first part assessed content appropriateness (score of 7-9 indicating appropriateness and 4-6 indicating possible appropriateness), while the second part assessed agreement (score of 5-9 indicating agreement). Results: The panel members developed 11 statements using the Delphi process, addressing the following topics: (1) clinical decision-making, (2) treatment, and (3) postoperative management about PCL injuries. The final consensus was reached on 11 statements and we eventually translated these statements into a corresponding table of expert recommendations. Conclusion: Consensus was reached on 11 statements regarding three aspects of PCL injury management. These findings provide a foundation for developing evidence-based guidelines that can enhance clinical decision-making, improve treatment strategies, and optimize postoperative care for patients with PCL injuries

Arthroscopic reconstruction of the acromioclavicular joint disruption: surgical technique and preliminary results.

Introduction: Numerous operative procedures have been described for the reconstruction of acromioclavicular joint separation; however, the arthroscopic reconstruction has been rarely reported. Therefore, our objective was to propose a new technique of arthroscopic acromioclavicular joint surgery and to evaluate the preliminary results. Materials and methods: Thirteen patients with a mean follow-up of 18 months underwent the arthroscopic acromioclavicular joint reconstruction using suture anchors and small titanium plate. The average age was 40.2 years (range 23-54 years). The shoulders were evaluated using Constant score and radiographs. The indications for surgery included acromioclavicular joint dislocation Rockwood type IV-V. Results: Twelve patients returned to their work without pain within 3 months after operation. The average Constant score at last follow-up was 95. Postoperative radiographs confirmed anatomic reduction in ten patients, residual subluxation in two patients and redislocation of the joint in one patient. One patient had radiographic evidence of coracoclavicular ossification. All patients but one were satisfied with results and cosmetic appearance. Conclusion: Considering its less morbidity, excellent cosmesis, no need of hardware removal, and minimal complications from breakage or migration of metal implants, this new technique offers an attractive alternative in acromioclavicular joint stabilization