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A Gender Based Comparative Analysis of Temperature Distribution in Human Knee Joint During Transient Therapeutic Heating

In this study, a real transient therapeutic heating situation has been simulated for analyzing and comparing the effect of gender-divergent tissue distribution on the thermal distribution profile in the interior of male and female knee joint. 3D geometric models of the knee joint have been constructed using SolidWorks® on the basis of the cross-sectional images of cadavers preserved in the Visible Human Project® (VHP). Post-construction, suitable meshes were generated using ANSYS® Workbench platform and the simulation was performed in COMSOL Multiphysics® interface employing Pennes bioheat equation with appropriate boundary conditions and tissue properties. If the application of external therapeutic heating modulates the neutral core temperature (37.2°C) within 38-44°C, the therapy is deemed to be effective for men with no risk of tissue damage. As the upper limit 44°C is achieved in the core when externally 57.6°C is applied on men, the general practice is to apply a bit lower external temperature for women to avoid the risk of tissue damage. From the results obtained, it can be observed that both the male and the female knee joint constituents are not susceptible to tissue damage having the core temperature within 38-44°C. For the bone, subcutaneous layer, adipose tissue, lateral and medial muscle, the simulation of the female knee respectively showed maximum percentage differences of 0.6144%, 2.6551%, 1.9959%, 3.3576% and 0.32278% compared to the male knee. In contrast to the expectation, all of the aforementioned tissues except bone have obtained lower core temperatures in female knee which subsequently indicates that due to the excess padding of subcutaneous layer in women, they require application of higher external temperature than men to achieve 44°C, the maximal core temperature allowable for effective therapeutic heating. In conclusion, the simulation results deliver a new insight to the clinical practice of thermal physiotherapy with adequate proof of concept. Yet for ensuring the patient safety, additional validation through in vivo experimental data is imperative prior clinical implementation.