Dataset Information

Posterior Root Tears of the Lateral Meniscus Only Affect Tibiofemoral Contact Forces when the Meniscofemoral Ligament Is Involved: A Cadaveric Study

ABSTRACT:

Purpose

The objective of this study was to examine the impact of progressive radial tears in the lateral meniscal root on the lateral compartment contact forces and joint surface area through a range of motion of knee and evaluate the role of the meniscofemoral ligament (MFL) in preventing adverse tibiofemoral joint forces.

Methods

Ten fresh frozen cadaveric knees were tested using 6 experimental conditions (0% lateral meniscal posterior root tear, 25% tear, 50% tear, 75% tear, 100% tear, 100% tear and resection of MFL) at five flexion angles (0°, 30°, 45°, 60°, and 90°) under 100-1,000-N axial load. Contact joint pressure and lateral compartment surface area were measured using Tekscan sensors. Statistical analysis, including descriptive, ANOVA, and post hoc Tukey analysis, was performed.

Results

Progressive radial tears of the lateral meniscal root were not associated with an increase in tibiofemoral contact pressure or decrease in lateral compartment surface area. Complete lateral root tear and resection of MFL were associated with increased joint contact pressure (P < .001) at knee flexion angles of 30, 45, 60, and 90° and decreased lateral compartment surface (P < .001) at all knee flexion angles area compared to complete lateral meniscectomy alone.

Conclusion

Isolated complete tears of lateral meniscus root and progressive radial tears of the lateral meniscus posterior root were not associated with any change to tibiofemoral contact forces. However, additional resection of the MFL increased contact pressure and decreased lateral compartment surface area.

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PROVIDER: S-EPMC10123502 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Project description:PurposeA paucity of data exists on the treatment of pediatric lateral meniscus root tears (LMPRTs). This study aims to characterize the biomechanics of the lateral knee joint in pediatric cadavers following LMPRT and root repair. Our hypotheses were: (1) compared with the intact state, LMPRT would be associated with decreased contact area; (2) compared with the intact state, LMPRT would be associated with increased contact pressures; and (3) compared with LMPRT, root repair would restore contact area and pressures toward intact meniscus values.MethodsEight cadaver knees (ages 8-12 years) underwent contact area and pressure testing of the lateral compartment. Tekscan pressure mapping sensors covering the tibial plateau were inserted underneath the lateral meniscus. Appropriate pressure load equivalents were applied by a robot at degrees of flexion: 0, 30, 60. Three meniscus conditions were tested: (1) intact, (2) complete root tear, and (3) repaired root tear. Root repairs were performed with transtibial pullout sutures. Statistical analysis was performed.ResultsRoot tear significantly decreased mean contact area at 30° (P = .0279) and 60° (P = .0397). Root repair increased mean contact area and did not significantly differ from intact states. Differences in contact pressures between meniscus states were not statistically significant. Relative to the intact state. the greatest increase in contact pressures occurred between 0° and 30°. Root repair decreased mean contact pressures at 0° and 30°. At 60°, mean contact pressures of the repair state were closer in magnitude to the tear state than the intact state. Conclusions: LMPRT decreases contact area and increases contact pressures in the lateral knee compartment. Repair of LMPRT improves tibiofemoral contact area at high (>30°) degrees of flexion and contact pressures at low (<30°) degrees of flexion.Clinical relevanceTransosseous pullout repair is a clinically validated treatment for LMPRT. This study provides baseline biomechanics data of transtibial pullout repair of pediatric LMPRTs.

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