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Knee Surgery, Sports Traumatology, Arthroscopy

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01-01-2015 | Knee

The effect of medial meniscal horn injury on knee stability

Authors: Lianxu Chen, Monica Linde-Rosen, Sun Chul Hwang, Jingbin Zhou, Qiang Xie, Patrick Smolinski, Freddie H. Fu

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2015

Abstract

Purpose

This study investigated the effect of damage of the posterior and anterior horns of the medial meniscus on knee stability.

Methods

Twenty fresh-frozen porcine knees were divided into two groups (anterior horn and posterior horn injury). Each group was tested in three states: intact medial meniscus, posterior or anterior horn of medial meniscus resection and total medial meniscectomy. A robotic testing system was used to test anterior tibial translation (ATT) at 30° (full extension), 60° and 90° of knee flexion with an external anterior tibial load of 89 N, internal rotation (IR) and external rotation (ER) at 30° and 60° of knee flexion under a 4 N m tibial rotation torque.

Results

In response to an IR torque, there was a significant difference between the state of intact medial meniscus and anterior and posterior horn damage, except for anterior horn resection at 60° of knee flexion. In response to an ER torque, there were no significant differences between the state of intact meniscus and horn damage except for anterior horn resection at 30° of knee flexion. Meniscal damage had no significant effect on ATT.

Conclusion

The results indicated that the posterior horn was more important in controlling the IR stability than the anterior horn with knee flexion, and the anterior horn was more important in controlling the ER stability than the posterior horn at full knee extension in the anterior cruciate ligament-intact knee. These findings further the understanding of the mechanisms, the prevention of injuries and rehabilitation of meniscal horn injury in clinical practice.

Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am 90(9):1922–1931PubMedCrossRef

Ahn JN, Bae TS, Kang Ks, Kang SY, Lee SH (2011) Longitudinal tear of the medial meniscus posterior horn in the anterior cruciate ligament-deficient knee significantly influences anterior stability. Am J Sports Med 39(10):2187–2193PubMedCrossRef

Berthiaume MJ, Raynauld JP, Martel-Pelletier J, Labonté F, Beaudoin G, Bloch DA, Choquette D, Haraoui B, Altman RD, Hochberg M, Meyer JM, Cline GA, Pelletier JP (2005) Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis 64(4):556–563PubMedCentralPubMedCrossRef

Bin SI, Kim JM, Shin SJ (2004) Radial tears of the posterior horn of the medial meniscus. Arthroscopy 20(4):373–378PubMedCrossRef

Brown TD, Shaw DT (1984) In vitro contact stress distribution on the femoral condyles. J Orthop Res 2(2):190–199PubMedCrossRef

Church S, Keating JF (2005) Reconstruction of the anterior cruciate ligament: timing of surgery and the incidence of meniscal tears and degenerative change. J Bone Joint Surg Br 87(12):1639–1642PubMedCrossRef

Costa CR, Morrison WB, Carrino JA (2004) Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear? Am J Roentgenol 183(1):17–23CrossRef

Debandi A, Maeyama A, Lu S, Hume C, Asai S, Goto B, Hoshino Y, Smolinski P, Fu F (2011) Biomechanical comparison of three anatomic ACL reconstruction in a porcine model. Knee Surg Sports Traumatol Arthrosc 19(5):728–735PubMedCrossRef

Fukuda Y, Takai S, Yoshino N, Murase K, Tsutsumi S, Ikeuchi K, Hirasawa Y (2000) Impact load transmission of the knee joint-influence of leg alignment and the role of meniscus and articular cartilage. Clin Biomech (Bristol, Avon) 15(7):516–521CrossRef

10.

Fuss FK (1991) Anatomy and function of the cruciate ligaments of the domestic pig (Sus scrofa domestica): a comparison with human cruciates. J Anat 178:11–20PubMedCentralPubMed

11.

Hennerbichler A, Moutos F, Hennerbichler D, Wienberg J, Guilak F (2007) Repair response of the inner and outer regions of the porcine meniscus in vitro. Am J Sports Med 15(5):754–762CrossRef

12.

Hoshino A, Wallace WA (1987) Impact-absorbing properties of the human knee. J Bone Joint Surg Br 69(5):807–811PubMed

13.

Johnson RJ, Coughlin KM (2003) Knee, meniscal biomechanics. In: DeLee JC, Drez DD (eds) DeLee and Drez’s orthopaedic sports medicine principles and practice, 2nd edn. Elsevier Science, Philadelphia, pp 1577–1594

14.

Kim YM, Joo YB, Cha SM, Hwang JM (2012) Role of the mechanical axis of lower limb and body weight in the horizontal tear and root ligament tear of the posterior horn of the medical meniscus. Int Orthop 36(9):1849–1855PubMedCentralPubMedCrossRef

15.

Kim YM, Joo YB (2013) Pullout failure strength of the posterior horn of the medial meniscus with root ligament tear. Knee Surg Sports Traumatol Arthrosc 21(7):1546–1552PubMedCrossRef

16.

Koenig JH, Ranawat AS, Umans HR, Difelice GS (2009) Meniscal root tears: diagnosis and treatment. Arthroscopy 25(9):1025–1032PubMedCrossRef

17.

Krause WR, Pope MH, Johnson RJ, Wilder DG (1976) Mechanical changes in the knee after meniscectomy. J Bone Joint Surg Am 58(5):599–604PubMed

18.

Levy IM, Torzilli PA, Gould JD, Warren RF (1989) The effect of lateral meniscectomy on motion of the knee. J Bone Joint Surg Am 71(3):401–406PubMed

19.

Markolf KL, Kochan A, Amstutz HC (1984) Measurement of knee stiffness and laxity in patients with documented absence of the anterior cruciate ligament. J Bone Joint Surg Am 66(2):242–252PubMed

20.

Markolf KL, Jackson SR, McAllister DR (2012) Force measurements in the medial meniscus posterior horn attachment: effects of anterior cruciate ligament removal. Am J Sports Med 40(2):332–338PubMedCrossRef

21.

Marzo JM, Kumar BA (2007) Primary repair of medial meniscal avulsions: 2 case studies. Am J Sports Med 35(8):1380–1383PubMedCrossRef

22.

Musahl V, Citak M, O’Loughlin PF, Choi D, Bedi A, Pearle AD (2010) The effect of medial versus lateral meniscectomy on the stability of the anterior cruciate ligament-deficient knee. Am J Sports Med 38(8):1591–1597PubMedCrossRef

23.

Naranje S, Mittal R, Nag H, Sharma R (2008) Arthroscopic and magnetic resonance imaging evaluation of meniscus lesions in the chronic anterior cruciate ligament–deficient knee. Arthroscopy 24(9):1045–1051PubMedCrossRef

24.

Navarro-Holgado P, Cuevas-Pérez A, Aguayo-Galeote MA, Carpintero-Benítez P (2007) Anterior medial meniscus detachment and anterior cruciate ligament tear. Knee Surg Sports Traumatol Arthrosc 15(5):587–590PubMedCrossRef

25.

Rath E, Richmond JC (2000) The menisci: Basic science and advances in treatment. Br J Sports Med 34:252–257PubMedCentralPubMedCrossRef

26.

Renstrom P, Johnson RJ (1990) Anatomy and biomechanics of the menisci. Clin Sports Med 9(3):523–538PubMed

27.

Rodkey WG (2000) Basic biology of the meniscus and response to injury. Instr Course Lect 49:189–193PubMed

28.

Seale KS, Haynes DW, Nelson CL, McLeod PC, Gerdes MH (1981) The effect of meniscectomy on knee stability. Trans Orthop Res Soc 6:236

29.

Senter C, Hame SL (2006) (2006) Biomechanical analysis of tibial torque and knee flexion angle: implications for understanding knee injury. Sports Med 36(8):635–641PubMedCrossRef

30.

Seon JK, Gadikota HR, Koznek M, Oh LS, Gill TJ, Li G (2009) The effect of ACL reconstruction on the kinematics of the knee with combined ACL injury and subtotal medial meniscectomy- an in-vitro robotic investigation. Arthro 25(2):123–130CrossRef

31.

Shoemaker SC, Markoff KL (1986) The role of the meniscus in the anterior -posterior stability of the loaded anterior cruciate-deficient knee. Effects of partial versus total excision. J Bone Joint Surg Am 68(1):71–79PubMed

32.

Urquhart MW, O’Leary JA, Giffin JR (2003) Meniscal injuries in the adult. In: DeLee JC, Drez DD (eds) DeLee and Drez’s orthopaedic sports medicine principles and practice, 2nd edn. Elsevier Science, Philadelphia, pp 1667–1676

33.

Voloshin AS, Wosk J (1983) Shock absorption of meniscectomized and painful knees: a comparative in vivo study. J Biomed Eng 5(2):157–161PubMedCrossRef

34.

Wang CJ, Walker PS (1974) Rotatory laxity of the human knee joint. J Bone Joint Surg Am 56(1):161–170PubMed

35.

Watanabe Y, Scyoc AV, Tsuda E, Debski RE, Woo SL (2004) Biomechanical function of the posterior horn of the medial meniscus: a human cadaveric study. J Orthop Sci 9(3):280–284PubMedCrossRef

36.

Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30(5):660–666PubMed

Title: The effect of medial meniscal horn injury on knee stability
Authors: Lianxu Chen
Monica Linde-Rosen
Sun Chul Hwang
Jingbin Zhou
Qiang Xie
Patrick Smolinski
Freddie H. Fu
Publication date: 01-01-2015
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-014-3241-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The effect of medial meniscal horn injury on knee stability

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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