Effect of Repair of Radial Tears at the Root of the Posterior Horn of the Medial Meniscus With the Pullout Suture Technique: A Biomechanical Study Using Porcine Knees

Seo, Jeong Hee; Li, Guoan; Shetty, Gautam M.; Kim, Ji Hoon; Bae, Ji Hoon; Jo, Myoung Lae; Kim, Jung Sung; Lee, Sung Jae; Nha, Kyung Wook

doi:10.1016/j.arthro.2009.05.014

Cited by 83 publications

(58 citation statements)

References 19 publications

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“…Instead of rigidly fixating the pullout sutures, the modified technique in this study ties the suture ends over a Hewson button (Ethicon) that was placed under the periosteum adjusting the tension. This technique allows the mobility of the meniscus for maximum dynamic congruity, and it facilitates load transmission of the meniscus avoiding excessive strain on the sutures [23,24]. In sum, this new proposed technique incorporates not only strong holding power, but the flexibility at the fixture point, as well.…”

Section: Discussionmentioning

confidence: 99%

Meniscus root refixation technique using a modified Mason–Allen stitch

Lee

Jang

et al. 2012

Knee Surg Sports Traumatol Arthrosc

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A complete posterior medial meniscus root tear results in the inability to withstand hoop stress and requires the repair of the posterior medial meniscus root. Several techniques to repair the posterior medial meniscus root have been proposed, but most techniques are based on simple stitching. A modified Mason-Allen technique, recognized as a superior stitching method to repair rotator cuff in shoulder surgery, was applied to overcome the potential weakness of those simple stitching techniques. This newly modified Mason-Allen technique reproduces the locking effect of a conventional modified Mason-Allen stitch allowing the physiological meniscal extrusion. The purpose of this article is to describe a posterior root repair technique using a modified Mason-Allen stitch with two strands consisting of a simple horizontal and a simple vertical stitch. Level of evidence V.

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Section: Discussionmentioning

confidence: 99%

Meniscus root refixation technique using a modified Mason–Allen stitch

Lee

Jang

et al. 2012

Knee Surg Sports Traumatol Arthrosc

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“…However, the one disadvantage was that the sensor could evaluate only up to a maximum of 300 N load. On the other hand, in a cadaveric study using pig specimens, Seo et al22) found a statistically significant increase in contact pressure when the knee was at 0° to 15° of extension after MMPRT repair that was performed at 30° to 90° of knee flexion. This study raised the issue that the currently implemented MMPRT repair would not be a complete treatment considering the risk of mechanical failure during knee extension that occurs in normal gait.…”

Section: Biomechanical Studies On Mmprtmentioning

confidence: 95%

“…The histograms show the peak contact pressure in the medial compartment at various knee angles under different meniscal conditions: (A) the study of Kim et al21); (B) the study of Allaire et al5); and (C) the study of Seo et al22).…”

Section: Figmentioning

confidence: 99%

Medial Meniscus Posterior Root Tear: A Comprehensive Review

Lee¹,

2014

Knee Surg Relat Res

106

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Damage to the medial meniscus root, for example by a complete radial tear, destroys the ability of the knee to withstand hoop strain, resulting in contact pressure increases and kinematic alterations. For these reasons, several techniques have been developed to repair the medial meniscus posterior root tear (MMPRT), many of which have shown complete healing of the repaired MMPRT. However, efforts to standardize or optimize the treatment for MMPRT are much needed. When planning a surgical intervention for an MMPRT, strict surgical indications regarding the effect of pullout strength on the refixed root, bony degenerative changes, mechanical alignment, and the Kellgren-Lawrence grade should be considered. Although there are several treatment options and controversies, the current trend is to repair the MMPRT using various techniques including suture anchors and pullout sutures if the patient meets the indications. However, there are still debates on the restoration of hoop tension and prevention of arthritis after repair and further biomechanical and clinical studies should be conducted in the future. The aim of this article was to review and summarize the recent literature regarding various diagnosis and treatment strategies of MMPRT, especially focusing on conflict issues including whether repair techniques can restore the main function of normal meniscus and which is the best suture technique to repair the MMPRT. The authors attempted to provide a comprehensive review of previous studies ranging from basic science to current surgical techniques.

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“…The use of different pressure sensors for in vitro tibiofemoral contact analyses has been previously reported for canine, 18 porcine, 28 sheep, 14,29 and human knee joints. 11,12 To place the pressure sensors under the menisci, the meniscotibial coronary ligaments had to be dissected, but this has no impact on the contact mechanics under axial compression.…”

Section: Influence Of Partial Meniscectomy On Knee Joint Biomechanicsmentioning

confidence: 99%

“…11,12 To place the pressure sensors under the menisci, the meniscotibial coronary ligaments had to be dissected, but this has no impact on the contact mechanics under axial compression. 30 The fixation of the sensor during axial loading is controversial; adhesives, 14,29 capsular sutures, 28 or autogenous inhibition through the applied axial load 11,12 are reported in literature. In our study no additional tool was used to secure the sensor, because no macroscopic sensor movement was observed during the loading cycles.…”

Section: Influence Of Partial Meniscectomy On Knee Joint Biomechanicsmentioning

confidence: 99%

Effect of partial meniscectomy at the medial posterior horn on tibiofemoral contact mechanics and meniscal hoop strains in human knees

Seitz

Lubomierski

Friemert³

et al. 2011

Journal Orthopaedic Research

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ABSTRACT:We examined the influence of partial meniscectomy of 10 mm width on 10 human cadaveric knee joints, as it is performed during the treatment of radial tears in the posterior horn of the medial meniscus, on maximum contact pressure, contact area (CA), and meniscal hoop strain in the lateral and medial knee compartments. In case of 08 and 308 flexion angle, 20% and 50% partial meniscectomy did not influence maximum contact pressure and area. Only in case of 608 knee flexion, 50% partial resection increased medial maximum contact pressure and decreased the medial CA statistically significant. However, 100% partial resection increased maximum contact pressure and decreased CA significantly in the meniscectomized medial knee compartment in all tested knee positions. No significant differences were noted for meniscal hoop strain. From a biomechanical point of view, our in vitro study suggests that the medial joint compartment is not in danger of accelerated cartilage degeneration up to a resection limit of 20% meniscal depth and 10 mm width. Contact mechanics are likely to be more sensitive to partial meniscectomy at higher flexion angles, which has to be further investigated. ß

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Effect of Repair of Radial Tears at the Root of the Posterior Horn of the Medial Meniscus With the Pullout Suture Technique: A Biomechanical Study Using Porcine Knees

Cited by 83 publications

References 19 publications

Meniscus root refixation technique using a modified Mason–Allen stitch

Meniscus root refixation technique using a modified Mason–Allen stitch

Medial Meniscus Posterior Root Tear: A Comprehensive Review

Effect of partial meniscectomy at the medial posterior horn on tibiofemoral contact mechanics and meniscal hoop strains in human knees

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