scholarly journals Methodology of Multicriterial Optimization of Geometric Features of an Orthopedic Implant

2021 ◽  
Vol 11 (22) ◽  
pp. 11070
Author(s):  
Małgorzata Muzalewska
Keyword(s):  
Anterior Cruciate Ligament ◽  
Immune System ◽  
Knee Joint ◽  
Artificial Immune System ◽  
Cruciate Ligament ◽  
Geometric Features ◽  
Orthopedic Implant ◽  
Artificial Immune ◽  
Geometrical Features ◽  
Anterior Cruciate

The main purpose of the article is to describe the methodology used for multi-criteria optimization of the geometric features of the orthopedic implant used for the reconstruction of the anterior cruciate ligament located in the knee joint. The methodology includes: 1. Method of development of the bones of the knee joint model; 2. Method of multi-criteria optimization of the geometric features of the orthopedic implant using an artificial immune system, the objective function and the Pareto front; 3. Expert evaluation method based on forms. The work confirmed that the assumed thesis, a multi-criteria optimization using an artificial immune system, which is a specially defined objective function, and the Pareto method, which allows to determine the geometrical features of the implant, will lead to fulfill optimal blood perfusion and sufficient strength properties of the implant simultaneously. We conclude that the described methodology allowed to achieve the optimal geometrical features of the orthopedic implant used for reconstruction of the anterior cruciate ligament located in the knee joint.

The Analysis of Proprioception Alteration during First Five Months after Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 1 (84) ◽  
Author(s):  
Vilma Jurevičienė ◽  
Albertas Skurvydas ◽  
Juozas Belickas ◽  
Giedra Bušmanienė ◽  
Dovilė Kielė ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Angular Velocity ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Starting Position ◽  
Angular Velocities ◽  
Anterior Cruciate

Research  background  and  hypothesis.  Proprioception  is  important  in  the  prevention  of  injuries  as  reduced proprioception  is  one  of  the  factors  contributing  to  injury  in  the  knee  joint,  particularly  the  ACL.  Therefore, proprioception appears not only important for the prevention of ACL injuries, but also for regaining full function after ACL reconstruction.Research aim. The aim of this study was to understand how proprioception is recovered four and five months after anterior cruciate ligament (ACL) reconstruction.Research methods. The study included 15 male subjects (age – 33.7 ± 2.49 years) who had undergone unilateral ACL reconstruction with a semitendinosus/gracilis (STG) graft in Kaunas Clinical Hospital. For proprioceptive assessment, joint position sense (JPS) was measured on both legs using an isokinetic dynamometer (Biodex), at knee flexion of 60° and 70°, and at different knee angular velocities of 2°/s and 10°/s. The patients were assessed preoperatively and after 4 and 5 months, postoperatively.Research results. Our study has shown that the JPS’s (joint position sense) error scores  to a controlled active movement is significantly higher in injured ACL-deficient knee than in the contralateral knee (normal knee) before surgery and after four and five months of rehabilitation.  After 4 and 5 months of rehabilitation we found significantly lower values in injured knees compared to the preoperative data. Our study has shown that in injured knee active angle reproduction errors after 4 and 5 months of rehabilitation were higher compared with the ones of the uninjured knee. Proprioceptive ability on the both legs was  independent of all differences angles for target and starting position for movement. The knee joint position sense on both legs depends upon the rate of two different angular velocities and the mean active angle reproduction errors at the test of angular velocity slow speed was the highest compared with the fast angular velocity. Discussion and conclusions. In conclusion, our study shows that there was improvement in mean JPS 4 and 5 months after ACL reconstruction, but it did not return to normal indices.Keywords: knee joint, joint position sense, angular velocity, starting position for movement.

Deconstructing the Anterior Cruciate Ligament: What We Know and Do Not Know About Function, Material Properties, and Injury Mechanics

2015 ◽  
Vol 137 (2) ◽  
Author(s):  
Scott G. McLean ◽  
Kaitlyn F. Mallett ◽  
Ellen M. Arruda
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Mechanical Response ◽  
Cruciate Ligament ◽  
Complex Structure ◽  
Acute Injury ◽  
Research Attention ◽  
Increased Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury is a common and potentially catastrophic knee joint injury, afflicting a large number of males and particularly females annually. Apart from the obvious acute injury events, it also presents with significant long-term morbidities, in which osteoarthritis (OA) is a frequent and debilitative outcome. With these facts in mind, a vast amount of research has been undertaken over the past five decades geared toward characterizing the structural and mechanical behaviors of the native ACL tissue under various external load applications. While these efforts have afforded important insights, both in terms of understanding treating and rehabilitating ACL injuries; injury rates, their well-established sex-based disparity, and long-term sequelae have endured. In reviewing the expanse of literature conducted to date in this area, this paper identifies important knowledge gaps that contribute directly to this long-standing clinical dilemma. In particular, the following limitations remain. First, minimal data exist that accurately describe native ACL mechanics under the extreme loading rates synonymous with actual injury. Second, current ACL mechanical data are typically derived from isolated and oversimplified strain estimates that fail to adequately capture the true 3D mechanical response of this anatomically complex structure. Third, graft tissues commonly chosen to reconstruct the ruptured ACL are mechanically suboptimal, being overdesigned for stiffness compared to the native tissue. The net result is an increased risk of rerupture and a modified and potentially hazardous habitual joint contact profile. These major limitations appear to warrant explicit research attention moving forward in order to successfully maintain/restore optimal knee joint function and long-term life quality in a large number of otherwise healthy individuals.

scholarly journals Effective Graft Preservation by Following a Standard Protocol for the Treatment of Knee Joint Infection after Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 32 (11) ◽  
pp. 1111-1120
Author(s):  
Robin Otchwemah ◽  
Jan-Hendrik Naendrup ◽  
Frauke Mattner ◽  
Thorsten Tjardes ◽  
Holger Bäthis ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Joint Infection ◽  
Standard Protocol ◽  
Standardized Protocol ◽  
Graft Preservation ◽  
Knee Joint Infection ◽  
Anterior Cruciate

AbstractKnee joint infections constitute a rare but devastating complication after anterior cruciate ligament (ACL) reconstruction. We hypothesized that effective infection therapy and graft preservation is possible following a standard treatment protocol. We retrospectively analyzed all patients admitted to our center with suspected infection of the knee after ACL reconstruction between 2010 and 2012. Following a standardized protocol, blood samples were drawn and synovial fluid was analyzed. Furthermore, the protocol consisted of arthroscopic lavages and debridements of the anterior and posterior joint compartments over three incisions, and targeted antibiotic therapy over a period of 6 weeks. Surgeries were repeated every 2 days until clinical signs of infections resolved, but at least two times. Mean observation period was 10 months. Forty-one patients aged 31 ( ±  9.9) years and admitted 14 ( ±  7.5) days after ACL reconstruction were included. Pathogens were found in 34 patients and coagulase-negative staphylococci were isolated most commonly (31 isolates in 28 patients). Quinolones were the most commonly used antibiotic agents. Mean number of operations was 3.8 ( ± 1.4). Following the standard protocol, primary successful infection treatment with graft preservation was possible in 37 of the included 41 patients. Graft preservation was achieved in 100% of the included patients with Gaechter stage 1 and 2 infections. Knee joint infection after ACL reconstruction was successfully treated following a standardized protocol, and graft preservation was reliably achieved especially in cases with infections at an early stage.

scholarly journals Comprehensive Rehabilitation After Reconstruction of the Anterior Cruciate Ligament

2021 ◽  
Vol 11 (8) ◽  
pp. 182-193
Author(s):  
Dawid Besztak ◽  
Karina Szczypiór-Piasecka ◽  
Alicja Mińko ◽  
Krzysztof Antczak
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
Rehabilitation Process ◽  
History Of ◽  
Comprehensive Rehabilitation ◽  
Anterior Cruciate ◽  
Two Stages ◽  
Hospital Rehabilitation

Introduction: The knee joint is the second most frequently injured joint. Anterior cruciate ligament (ACL) injury is a relatively common injury to the inner part of the knee joint, mainly related to contact sports. Its rupture leads to instability of the entire joint. Two treatment options are possible: operative or conservative. Each of them is related to an appropriate rehabilitation process. The aim of this study was to define a comprehensive rehabilitation plan in patients after ACL rupture and meniscal suturing.Materials and methods: The work was written based on the medical history of the patient who was diagnosed with complete rupture of ACL, and then reconstruction was performed with the harvesting of a semitendinous and slender muscle graft.Results: The rehabilitation process can be divided into two stages: hospital and post-hospital. Rehabilitation in hospital conditions begins on the zero day after arthroscopy. The main goals of rehabilitation include: increasing the range of mobility, no myofascial dysfunctions, no thromboembolic complications, and the ability to self-service.Conclusion: Rehabilitation is an indispensable element of the treatment of patients after ACL reconstruction. Early initiation of rehabilitation brings tangible benefits during treatment and return to full physical fitness.

scholarly journals Microvasculature of Anterior Cruciate Ligament by Immunohistochemistry using VE-Cadherin

2020 ◽  
Vol 6 (1) ◽  
pp. 58-61
Author(s):  
Jahira Banu T ◽  
Yogesh Ashok Sontakke
Keyword(s):  
Anterior Cruciate Ligament ◽  
Postoperative Complications ◽  
Knee Joint ◽  
Blood Vessels ◽  
Transmembrane Protein ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Middle Part ◽  
The Past ◽  
Anterior Cruciate

Introduction: The anterior cruciate ligament (ACL) is one of the knee stabilizer and acts to prevent excessive anterior mobility as well as rotational movement. The ACL is extending from the lateral femoral condyle to the anterior intercondylar area of tibia. During excessive movement or abnormal mobility affecting the knee joint, the ACL is under tension and prone for injury. The injured ACL was managed by surgery as it was an option for treatment owing to its poor vascularity. The distribution of the blood vessels within the ACL was not clear and only few studies reported in the past. The present study focused on distribution of blood vessels in the ACL. Subjects and Methods: The ACL microvasculature was assessed using 48 cadaveric ACL tissues using immunohistochemistry. The antibody against the transmembrane protein VE-Cadherin was targeted to study the blood vessels. Results: It was observed that the middle part of the ACL was less vascular compared with the peripheral parts of ACL. Conclusion: The knowledge of the ACL vasculature may help in planning surgeries of ACL to reduce postoperative complications.

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