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Drainage after total knee replacement

Published online by Cambridge University Press:  17 February 2009

G. Sterling ,
G. D. McBain ,
J. A. Harris  and
M. Boland
G. Sterling
Affiliation:
Department of Orthopædics, Townsville General Hospital, Townsville, QLD, Australia.
G. D. McBain
Affiliation:
School of Aerospace, Mechanical, and Mechatronic Engineering, The University of Sydney, NSW, Australia.
J. A. Harris
Affiliation:
Maunsell Australia Pty Ltd, 21 Stokes St, Townsville QLD, Australia.
M. Boland
Affiliation:
Department of Orthopædics, Townsville General Hospital, Townsville, QLD, Australia.
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Abstract

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A simple lumped hydraulic model of knee drainage following arthroplasty is developed incorporating a pressure-volume equation of state for the knee capsule and a wound healing rate dynamically retarded by the blood flow-induced shear stress. The resulting second-order nonlinear ordinary differential system is examined numerically and qualitatively to map the parameter space. In the model, moderate suction or a slight back-pressure promotes gradual drainage and healing whereas excessive suction can lead to a bifurcation in which healing is retarded or even prevented. Guided, then, by the model, the literature, and experience, continuous drainage with a small constant back-pressure appeared beneficial so we prospectively evaluated a series of ten patients. The results are consistent with the model and promising.

Keywords

wound bleedingwound healingblood-flow shear-retarded healingnonlinear ordinary diffrential systemphase plane analysis
Type
Research Article
Information
The ANZIAM Journal , Volume 48 , Issue 2 , October 2006 , pp. 199 - 210
Copyright
Copyright © Australian Mathematical Society 2006

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