Biological and Mechanical Predictors of Meniscus Function: Basic Science to Clinical Translation

Rodeo, Scott A.; Monibi, Farrah; Dehghani, Bijan; Maher, Suzanne A.

doi:10.1002/jor.24552

Cited by 22 publications

(15 citation statements)

References 74 publications

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Section: Meniscus Response To Loadingmentioning

confidence: 99%

“…Ultimately, loading affects the properties of menisci but we know very little about how to optimize load magnitude, type, and duration to encourage healing [116]. Immobilization is not supported by the evidence, but a period of time with partial WB following meniscal injury, repair, or partial meniscectomy has been found to result in improved outcomes [116]. Recently, the anabolic activity of collagen was studied over the lifetime of 25 human menisci, 18 with knee osteoarthritis and 7 without using 14C bomb pulse timing and results indicated that there was negligible turnover of collagen in any of the adult menisci [97].…”

Section: Meniscus Response To Loadingmentioning

confidence: 99%

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Effects of and Response to Mechanical Loading on the Knee

et al. 2021

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Mechanical loading to the knee joint results in a differential response based on the local capacity of the tissues (ligament, tendon, meniscus, cartilage, and bone) and how those tissues subsequently adapt to that load at the molecular and cellular level. Participation in cutting, pivoting, and jumping sports predisposes the knee to the risk of injury. In this narrative review, we describe different mechanisms of loading that can result in excessive loads to the knee, leading to ligamentous, musculotendinous, meniscal, and chondral injuries or maladaptations. Following injury (or surgery) to structures around the knee, the primary goal of rehabilitation is to maximize the patient's response to exercise at the current level of function, while minimizing the risk of re-injury to the healing tissue. Clinicians should have a clear understanding of the specific injured tissue(s), and rehabilitation should be driven by knowledge of tissue-healing constraints, knee complex and lower extremity biomechanics, neuromuscular physiology, task-specific activities involving weight-bearing and non-weight-bearing conditions, and training principles. We provide a practical application for prescribing loading progressions of exercises, functional activities, and mobility tasks based on their mechanical load profile to knee-specific structures during the rehabilitation process. Various loading interventions can be used by clinicians to produce physical stress to address body function, physical impairments, activity limitations, and participation restrictions. By modifying the mechanical load elements, clinicians can alter the tissue adaptations, facilitate motor learning, and resolve corresponding physical impairments. Providing different loads that create variable tensile, compressive, and shear deformation on the tissue through mechanotransduction and specificity can promote the appropriate stress adaptations to increase tissue capacity and injury tolerance. Tools for monitoring rehabilitation training loads to the knee are proposed to assess the reactivity of the knee joint to mechanical loading to monitor excessive mechanical loads and facilitate optimal rehabilitation. Key PointsMechanical loads encountered during high-risk cutting, pivoting, and jumping sports predispose the structures of the knee to risk of injury.Individual tissues of the knee respond and adapt differently to various mechanical load stimuli.

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Section: Meniscus Response To Loadingmentioning

confidence: 99%

Section: Meniscus Response To Loadingmentioning

confidence: 99%

Effects of and Response to Mechanical Loading on the Knee

et al. 2021

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“…With the progress of research, KOA is not only a single disease of articular cartilage degeneration but an organ-related disease affecting whole joint tissues, including articular cartilage, subchondral bone, synovium, meniscus, ligaments, joint capsules, and periarticular muscles [7][8][9] . Although meniscus dysfunction may be present in asymptomatic knees or in knees with no evidence of OA, meniscal degeneration is one of the most vital risk factors for KOA, and partial meniscectomy is the most common type of orthopedic surgery for inducing KOA animals and promotes KOA progression including cartilage damage and synovitis [9][10][11][12][13] . In the process of KOA, pathological changes mainly include cartilage degeneration, synovial inflammation, subchondral sclerosis, and osteophyte formation 14 .…”

Section: Articular Microenvironment and Koamentioning

confidence: 99%

Compositional Variation and Functional Mechanism of Exosomes in the Articular Microenvironment in Knee Osteoarthritis

Zheng

et al. 2020

Cell Transplant

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Osteoarthritis (OA) is a major cause of disability worldwide with increasing age. Knee OA (KOA) is the most prevalent type of OA. Recently, it is considered that KOA is a whole joint disease, including articular cartilage, subchondral bone, synovium, ligaments, joint capsules, and muscles around the joint. Exosomes in knee joint are mainly secreted by articular chondrocytes and synoviocytes. They participate in cell and tissue cross-talk by carrying a complex cargo of proteins, lipids, nucleic acids, etc. Under normal conditions, exosomes maintain the microenvironmental homeostasis of the joint cavity. Under pathological conditions, the composition and function of exosomes changes, which in turn, disrupts the balance of anabolism and catabolism of articular chondrocyte and facilitates inflammatory responses, thus accelerating KOA progression. As a regenerative medicine, mesenchymal stem cells (MSCs) are promised to facilitate repair of degenerated cartilage and decelerate OA process. The therapeutic function of MSC mainly depends on MSC-derived exosomes, which can restore the homeostasis of the articular microenvironment. In the future, the specific mechanism of exosomes for OA treatment needs further elucidation, and the treatment effect of exosomes for long-term and/or severe OA needs further exploration.

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“…It was not that long ago when menisci were thought to be functionless embryonic residue [5]. Nowadays, injuries to the menisci are recognized as a cause of significant musculoskeletal morbidity and an important cause of knee osteoarthritis [6]. Vast improvements in the overall understanding of meniscus biomechanics have been made over the past forty years.…”

Section: Introductionmentioning

confidence: 99%

Evolution of knowledge on meniscal biomechanics: a 40 year perspective

Mohamadi

Momenzadeh

Masoudi

et al. 2021

BMC Musculoskelet Disord

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Background Knowledge regarding the biomechanics of the meniscus has grown exponentially throughout the last four decades. Numerous studies have helped develop this knowledge, but these studies have varied widely in their approach to analyzing the meniscus. As one of the subcategories of mechanical phenomena Medical Subject Headings (MeSH) terms, mechanical stress was introduced in 1973. This study aims to provide an up-to-date chronological overview and highlights the evolutionary comprehension and understanding of meniscus biomechanics over the past forty years. Methods A literature review was conducted in April 2021 through PubMed. As a result, fifty-seven papers were chosen for this narrative review and divided into categories; Cadaveric, Finite element (FE) modeling, and Kinematic studies. Results Investigations in the 1970s and 1980s focused primarily on cadaveric biomechanics. These studies have generated the fundamental knowledge basis for the emergence of FE model studies in the 1990s. As FE model studies started to show comparable results to the gold standard cadaveric models in the 2000s, the need for understanding changes in tissue stress during various movements triggered the start of cadaveric and FE model studies on kinematics. Conclusion This study focuses on a chronological examination of studies on meniscus biomechanics in order to introduce concepts, theories, methods, and developments achieved over the past 40 years and also to identify the likely direction for future research. The biomechanics of intact meniscus and various types of meniscal tears has been broadly studied. Nevertheless, the biomechanics of meniscal tears, meniscectomy, or repairs in the knee with other concurrent problems such as torn cruciate ligaments or genu-valgum or genu-varum have not been extensively studied.

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Biological and Mechanical Predictors of Meniscus Function: Basic Science to Clinical Translation

Cited by 22 publications

References 74 publications

Effects of and Response to Mechanical Loading on the Knee

Effects of and Response to Mechanical Loading on the Knee

Compositional Variation and Functional Mechanism of Exosomes in the Articular Microenvironment in Knee Osteoarthritis

Evolution of knowledge on meniscal biomechanics: a 40 year perspective

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