Tibiofemoral Contact Mechanics after Serial Medial Meniscectomies in the Human Cadaveric Knee

Abstract

Because the degree of meniscectomy leading to clinically significant outcomes is unknown, a prudent strategy is to preserve the greatest amount of meniscus possible.

Dynamic Contact Mechanics of the Medial Meniscus as a Function of Radial Tear, Repair, and Partial Meniscectomy

“…1, right). Pilot work that involved testing and retesting of an intact knee indicated that the osteotomy led to a change in peak contact pressure of approximately 5%; this observation is similar to that reported by Lee et al 28 and by Martens et al 40 , who found that such an osteotomy had little effect on measured joint contact pressure.…”

“…The model used for this study was based on technology developed to evaluate the wear performance of total knee replacements-i.e., the Stanmore KC Knee Joint Simulator 36 . Unlike static or quasi-static models that provide data at discrete points in the gait cycle, the simulator allows knees to be dynamically and continuously loaded under conditions that simulate gait 28,31,34,48 . It is a force-controlled apparatus than can be programmed to simultaneously and dynamically control the axial force, anterior force, posterior force, and rotational moment (internal/external torque) as a function of the applied flexion/extension angle profile.…”

“…Indeed, degenerative changes associated with meniscectomies have been linked to increased joint contact stress (hereafter referred to as contact pressure) in the adjacent articular cartilage as measured in vitro [18][19][20][21][22][23][24][25][26][27] . To date, however, experimental models have been primarily conducted under static or quasi-static uniaxial loading conditions 8,[28][29][30][31][32][33] . Given the sensitivity of joint contact pressures to the magnitude and direction of an applied load 34,35 , these models do not accurately capture the physiological effect of meniscal repair or meniscectomy on knee contact mechanics.…”

Meniscal Repair Outcomes at Greater Than Five Years

“…The meniscus is vital to normal function and longevity of the knee, as meniscal loss causes increased contact pressures and articular cartilage degeneration [3][4][5][6][7][8] . Meniscal repair techniques have evolved substantially in the last few decades, with open techniques replaced by arthroscopic techniques.…”

Meniscal Allograft Transplantation: Where are we Standing?

“…The number of meniscectomies for the treatment of meniscal tears has risen dramatically in the last decades, especially with the advancement of arthroscopy. However, the management of meniscal ruptures is currently changing with the better understanding of meniscal function and better knowledge on the short-to-mid-term consequences of meniscectomy on the articular cartilage: osteoarthritis [3][4][5]. As a consequence, nowadays most orthopaedic surgeons try to preserve as much meniscal tissue as possible or make an attempt for meniscal repair [6].…”