The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee

Lorbach, Olaf; Kieb, Matthias; Herbort, Mirco; Weyers, Imke; Raschke, Michael J.; Engelhardt, Martin

doi:10.1007/s00264-014-2581-x

Cited by 63 publications

(64 citation statements)

References 43 publications

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“…Therefore, it is expected that laxity's changes are easier to detect in an in vivo set-up. Lorbach et al [11], testing cadaveric specimens, found that partial or total meniscectomy of the medial meniscus determine a significant impact on knee kinematics in the ACL-deficient knee evaluated by Lachman and pivot-shift test, whereas the repair of the meniscus was able to reduce it, similar to the ACL-deficient knee with intact meniscus.…”

Section: Discussionmentioning

confidence: 99%

“…Lorbach et al [11,Abstract Purpose The purpose of the present study was to determine, in vivo, the effect of different types of meniscectomy on an ACL-deficient knee. Methods Using a computer-assisted navigation system, 56 consecutive patients (45 men and 11 women) were subjected to a biomechanical testing with Lachman test (AP30), drawer test (AP90), internal/external rotation test, varus/valgus rotation test and pivot-shift test.…”

Section: Introductionmentioning

confidence: 99%

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Does meniscus removal affect ACL-deficient knee laxity? An in vivo study

Zaffagnini

Signorelli

Bonanzinga

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does meniscus removal affect ACL-deficient knee laxity? An in vivo study

Zaffagnini

Signorelli

Bonanzinga

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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show abstract

“…A single radial cut is equivalent to meniscectomy as it cuts off the hoof stresses across the circumferential fibers of the meniscus. Medial meniscectomy has been found to increase anterior tibial translation in ACL deficient knees by Lorbach et al [4] Total lateral meniscectomy is also associated with increase posterolateral rotary instability postoperatively due to its anatomical proximity to popliteus tendon and postero lateral capsule. Laprade et al has shown the importance of lateral meniscus in ACL reconstructed knees.…”

Section: Resultsmentioning

confidence: 99%

“…They also contribute mechanical stability of the knee along with cruciate ligaments specially rotary stability giving additional gliding function to the hinge type of knee joint [9] . Meniscectomy has bad influence on joint alignment, load distribution and anterior instablilty [3,4,5] . Medial meniscectomy increases tibio femoral contact stresses by 100% whereas lateral meniscectomy increases contact stresses by 200% to 300%.…”

Section: Resultsmentioning

confidence: 99%

“…Follow up as long as 40 years after medial meniscectomy has shown reduced femoro tibial angle leading to varus malalignment and lower flexion range of the knee [3] . Lorbach et al has shown that medial meniscectomy increases anterior tibial translation in ACL deficient knees by significant amount by Lorbach et al [4,5] Total lateral meniscectomy or its untreated root tear is also associated with increase posterolateral rotary instability postoperatively due to its anatomical proximity to popliteus tendon and posterolateral capsule [6] . Meniscus repair has higher healing potential.…”

Section: Introductionmentioning

confidence: 99%

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Influence of meniscal repair versus meniscectomy on ACL reconstruction in terms of knee stability and radiological imaging

Deore¹,

Patil²,

Kale³

et al. 2017

Int. J. Orthop. Sci.

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Objective: To compare effect of meniscus repair and meniscectomy in patients undergoing ACL reconstruction in terms of clinical instability and radiological tunnel widening 1 year after surgery. Introduction: Meniscectomy has been shown to have detrimental effects on knee in terms of increased contact pressure in femoral and tibial condyles, rotary instability and early changes of osteoarthritis. These changes are exaggerated in ACL deficient knees. Patients present to the surgeon at different times after injury ranging from 3 weeks to one year. Depending upon status of meniscal tears and its reparability at the time of surgery, surgeon has to choose between meniscectomy and meniscus repair during ACL reconstruction. We tried to compare meniscus repair and meniscectomy in terms of knee stability and radiological tunnel widening after ACL reconstruction in short term follow up. Methodology: 30 patients who underwent ACL reconstruction were selected after going through selection criteria, were divided between meniscus repair group and meniscus excision group. Meniscus tears, which were in the red red zone were repaired with inside out, all inside and outside in methods, depending upon their location from anterior to posterior zones. Those tears which presented late were irreducible, avascular and became loose body scuffing articular cartilage, were excised with shaver. All patients underwent standard ACL reconstruction with hamstring graft. Patients were evaluated clinically and radiologically at 3 months 6 months and 12 months. Results: Group 1 had 14 patients who underwent meniscus repair and group 2 had 16 patients who underwent meniscectomy during ACL reconstruction. Evaluation with Lachman's test showed that, 14% patients (2 out of 14) from Group 1 had grade 2 Lachman test. Thirty seven % of group 2 had grade 2 Lachman test though the difference was not significant (p = 0.151). Tibial tunnel diameter in meniscectomy group increased from 8 mm to 11.86mm (S.D= 1.11.) at 12 months. Tibial diameter in group 2 increased from 8 mm to 12.28 mm (S.D. = 1.52), (p= 0.394). Conclusion: Whenever ACL tear is associated with medial or lateral meniscal tears, meniscal repair is the preferred treatment over meniscectomy. The amount of tunnel widening is higher when meniscus is excised as compared to meniscal repair. The anterior tibial translation remains higher when meniscus is excised during ACL reconstruction, though short term functional results are same.

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Medial meniscal lesions increase antero‐posterior laxity in knees with anterior cruciate ligament injury

Franceschini,

Reale,

Boffa

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to quantify the impact of concomitant meniscal lesions on knee laxity using a triaxial accelerometer in a large population of patients affected by anterior cruciate ligament (ACL) injury.MethodsA total of 326 consecutive patients (261 men and 65 women, mean age 31.3 ± 11.3) undergoing primary ACL reconstruction, were preoperatively evaluated through Lachman and pivot shift tests using a triaxial accelerometer to quantify knee laxity. An analysis based on the presence of meniscal tears assessed during surgery was performed to evaluate the impact of meniscal lesions on knee laxity.ResultsThe anterior tibial translation (Lachman test) presented significantly higher values in patients with medial meniscal lesions (7.3 ± 1.7 mm, p = 0.049) and both medial and lateral meniscal lesions (7.7 ± 1.6 mm, p = 0.001) compared to patients without concomitant meniscal lesions (6.7 ± 1.3 mm). Moreover, patients with both medial and lateral meniscal lesions presented significantly higher values of anterior tibial translation compared to patients with lateral meniscal lesions (p = 0.049). No statistically significant differences were found between the groups in terms of tibial acceleration (pivot shift test).ConclusionThis study demonstrated that the contribution of concomitant meniscal lesions to knee laxity can be objectively quantified using a triaxial accelerometer in ACL‐injured knees. In particular, medial meniscus lesions, alone or in association with lateral meniscus lesions, determine a significant increase of the anterior tibial translation compared to knees without meniscus tears.Level of EvidenceLevel IV.

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The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee

Cited by 63 publications

References 43 publications

Does meniscus removal affect ACL-deficient knee laxity? An in vivo study

Does meniscus removal affect ACL-deficient knee laxity? An in vivo study

Influence of meniscal repair versus meniscectomy on ACL reconstruction in terms of knee stability and radiological imaging

Medial meniscal lesions increase antero‐posterior laxity in knees with anterior cruciate ligament injury

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