Www.sori.com.au The effect of graft position for a single bundle ACL reconstruction – FEA Study Ravi Sundaramurthy (B.Eng Biomedical) Dr. David Parker.

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Presentation transcript:

The effect of graft position for a single bundle ACL reconstruction – FEA Study Ravi Sundaramurthy (B.Eng Biomedical) Dr. David Parker (FRACS) Dr. Qing Li (PhD, University of Sydney)

Background- Graft Placement Isometric Isometric Minimum strain of graft Minimum strain of graft Preserves the life of the graft longest Preserves the life of the graft longest Knee biomechanics not represented Knee biomechanics not represented Anatomical Anatomical Placed at footprint of original ACL Placed at footprint of original ACL Approximates knee biomechanics better Approximates knee biomechanics better Higher failure rates, stretching etc Higher failure rates, stretching etc

Literature Review Several FEA models on knee Donohue et al, 2002 etc Very few studies on ACL reconstruction using FEA models Pena E et al, 2005* *Pena E et al, Influence of the tunnel angle in ACL reconstructions on the biomechanics of the knee joint, Clinical Biomechanics, 2006, p

Aims Build an accurate FE model of the knee Analyse effect of changing ACL graft position on Biomechanics of the knee Stress and strain on the graft and major ligaments

Methods Describe what was actually done Created a FE Model of knee using what program? How many knees did you use?

Assumptions in the Model Meniscus and articular cartilage not modelled Muscles (Passive and active) not modelled Knee is modelled in Full Extension Ligament is modelled as linear non-viscoelastic Pre-tensioning of ligaments and grafts not considered

Graft Positioning

Result Anterior Tibial Loading N Posterior Femoral Load

Results External Tibial Rotation 5 N.m External Torque

LCL Stresses and Strain

Internal Tibial Rotation 5 N.m Internal Tibial Rotation

Internal Tibial Rotation No ACL Loading

Conclusion Several trends were observed in ligament stress, strain and knee kinematics with varying graft position An alternative method to clinical studies was used to study effect of graft position

Future Directions Effect of Different Flexion Angles Model ligaments as non-linear viscoelastic Study effect of muscles, meniscus etc Study Double Bundle technique Study effect of more graft materials