BACKGROUND: There is still little known regarding the effects of meniscus resection size on tibiofemoral stability. PURPOSE: To determine if partial medial meniscectomy of the posterior horn significantly alters tibiofemoral stability as measured by the anterior-posterior (AP) position and laxity of the medial femoral condyle. STUDY DESIGN: Controlled laboratory study. METHODS: Five cadaveric knees were dissected to the capsule, preserving all ligaments and the quadriceps tendon. Each specimen was first tested on a rig where the AP position and laxity of the medial femoral condyle were measured while a range of forces was applied from full extension to 90° of flexion. Magnetic resonance imaging (MRI) at 3 tesla was then performed for baseline measurements of the meniscus before partial meniscectomy. Arthroscopic partial medial meniscectomy aimed at 30% of the posterior horn was then performed, followed by repeat mechanical testing and MRI. The sequence was then repeated for arthroscopic partial meniscectomy aimed at 60% and 100% of the posterior horn of the medial meniscus. RESULTS: The MRI analysis demonstrated that 22% ± 9% of the original width of the posterior horn was removed at the first resection, 46% ± 11% was removed at the second resection, and the third resection was 100% removal of the posterior horn for all specimens. After 22% resection, no significant difference in AP laxity was observed. A statistically significant increase in AP laxity was observed with 46% resection under a 500-N compressive load compared with the intact meniscus. After full resection, significant increases in AP laxity were observed under a 50-N compressive load compared with the intact and 22% and 46% resections. The 22% resection had similar AP positions as the intact knee, whereas the 46% resection and 100% removal of the posterior horn had statistically further posterior AP positions than the intact knee. CONCLUSION: Partial medial meniscectomy with ≥46% resection of the original width of the posterior horn significantly altered the AP position of the medial femoral condyle and also increased laxity. CLINICAL RELEVANCE: These mechanical changes may lead to abnormal cartilage loading and early osteoarthritis.
BACKGROUND: There is still little known regarding the effects of meniscus resection size on tibiofemoral stability. PURPOSE: To determine if partial medial meniscectomy of the posterior horn significantly alters tibiofemoral stability as measured by the anterior-posterior (AP) position and laxity of the medial femoral condyle. STUDY DESIGN: Controlled laboratory study. METHODS: Five cadaveric knees were dissected to the capsule, preserving all ligaments and the quadriceps tendon. Each specimen was first tested on a rig where the AP position and laxity of the medial femoral condyle were measured while a range of forces was applied from full extension to 90° of flexion. Magnetic resonance imaging (MRI) at 3 tesla was then performed for baseline measurements of the meniscus before partial meniscectomy. Arthroscopic partial medial meniscectomy aimed at 30% of the posterior horn was then performed, followed by repeat mechanical testing and MRI. The sequence was then repeated for arthroscopic partial meniscectomy aimed at 60% and 100% of the posterior horn of the medial meniscus. RESULTS: The MRI analysis demonstrated that 22% ± 9% of the original width of the posterior horn was removed at the first resection, 46% ± 11% was removed at the second resection, and the third resection was 100% removal of the posterior horn for all specimens. After 22% resection, no significant difference in AP laxity was observed. A statistically significant increase in AP laxity was observed with 46% resection under a 500-N compressive load compared with the intact meniscus. After full resection, significant increases in AP laxity were observed under a 50-N compressive load compared with the intact and 22% and 46% resections. The 22% resection had similar AP positions as the intact knee, whereas the 46% resection and 100% removal of the posterior horn had statistically further posterior AP positions than the intact knee. CONCLUSION: Partial medial meniscectomy with ≥46% resection of the original width of the posterior horn significantly altered the AP position of the medial femoral condyle and also increased laxity. CLINICAL RELEVANCE: These mechanical changes may lead to abnormal cartilage loading and early osteoarthritis.
Authors: Justin W Griffin; Michael M Hadeed; Brian C Werner; David R Diduch; Eric W Carson; Mark D Miller Journal: Clin Orthop Relat Res Date: 2015-02-06 Impact factor: 4.176
Authors: Sally Arno; Christopher P Bell; Michael J Alaia; Brian C Singh; Laith M Jazrawi; Peter S Walker; Ankit Bansal; Garret Garofolo; Orrin H Sherman Journal: Clin Orthop Relat Res Date: 2016-04-22 Impact factor: 4.176
Authors: A C T Vrancken; S P M Crijns; M J M Ploegmakers; C O'Kane; T G van Tienen; D Janssen; P Buma; N Verdonschot Journal: J Anat Date: 2014-07-23 Impact factor: 2.610
Authors: Hongsheng Wang; Albert O Gee; Ian D Hutchinson; Kirsten Stoner; Russell F Warren; Tony O Chen; Suzanne A Maher Journal: Am J Sports Med Date: 2014-04-28 Impact factor: 6.202
Authors: H Wang; T Chen; A O Gee; I D Hutchinson; K Stoner; R F Warren; S A Rodeo; S A Maher Journal: Osteoarthritis Cartilage Date: 2014-12-09 Impact factor: 6.576