A C T Vrancken1, T G van Tienen2, G Hannink3, D Janssen3, N Verdonschot4, P Buma3. 1. Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: Anne.Vrancken@radboudumc.nl. 2. Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Orthopaedic Surgery, Via Sana Clinic, Mill, The Netherlands. 3. Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands. 4. Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands; Laboratory for Biomechanical Engineering, University of Twente, Enschede, The Netherlands.
Abstract
BACKGROUND: Meniscal functioning depends on the fixation between the meniscal horns and the surrounding tissues. It is unknown, however, whether the integration between the outer circumference of the medial meniscus and the knee capsule/medial collateral ligament also influences the biomechanical behavior of the meniscus. Therefore, we aimed to determine whether detaching and resuturing the circumferential fixation of the medial meniscus influence its kinematic pattern. METHODS: Human cadaveric knee joints were flexed (0°-30°-60°-90°) in a knee loading rig, in neutral orientation and under internal and external tibial torques. Roentgen stereophotogrammetric analysis was used to determine the motion of the meniscus in anteroposterior (AP) and mediolateral (ML) directions. Three fixation conditions were evaluated: (I) intact, (II) detached and (III) resutured. RESULTS: Detaching and resuturing the circumferential fixation did not alter the meniscal motion pattern in either the AP or ML direction. Applying an additional internal tibial torque caused the medial meniscus to move slightly anteriorly, and an external torque caused a little posterior translation with respect to the neutral situation. These patterns did not change when the circumferential fixation condition was altered. CONCLUSIONS: This study demonstrated that the motion pattern of the medial meniscus is independent of its fixation to the knee capsule and medial collateral ligament. CLINICAL RELEVANCE: The outcomes of this study can be deployed to design the fixation strategy of a permanent meniscus prosthesis. As peripheral fixation is a complicated step during meniscal replacement, the surgical procedure is considerably simplified when non-resorbable implants do not require circumferential fixation.
BACKGROUND: Meniscal functioning depends on the fixation between the meniscal horns and the surrounding tissues. It is unknown, however, whether the integration between the outer circumference of the medial meniscus and the knee capsule/medial collateral ligament also influences the biomechanical behavior of the meniscus. Therefore, we aimed to determine whether detaching and resuturing the circumferential fixation of the medial meniscus influence its kinematic pattern. METHODS:Human cadaveric knee joints were flexed (0°-30°-60°-90°) in a knee loading rig, in neutral orientation and under internal and external tibial torques. Roentgen stereophotogrammetric analysis was used to determine the motion of the meniscus in anteroposterior (AP) and mediolateral (ML) directions. Three fixation conditions were evaluated: (I) intact, (II) detached and (III) resutured. RESULTS: Detaching and resuturing the circumferential fixation did not alter the meniscal motion pattern in either the AP or ML direction. Applying an additional internal tibial torque caused the medial meniscus to move slightly anteriorly, and an external torque caused a little posterior translation with respect to the neutral situation. These patterns did not change when the circumferential fixation condition was altered. CONCLUSIONS: This study demonstrated that the motion pattern of the medial meniscus is independent of its fixation to the knee capsule and medial collateral ligament. CLINICAL RELEVANCE: The outcomes of this study can be deployed to design the fixation strategy of a permanent meniscus prosthesis. As peripheral fixation is a complicated step during meniscal replacement, the surgical procedure is considerably simplified when non-resorbable implants do not require circumferential fixation.
Authors: A C T Vrancken; F Eggermont; T G van Tienen; G Hannink; P Buma; D Janssen; N Verdonschot Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-05-14 Impact factor: 4.342
Authors: Hamid Naghibi; Dennis Janssen; Ton van den Boogaard; Tony van Tienen; Nico Verdonschot Journal: Med Biol Eng Comput Date: 2020-04-11 Impact factor: 2.602
Authors: Brian E Walczak; Kyle Miller; Michael A Behun; Lisa Sienkiewicz; Heather Hartwig Stokes; Ron McCabe; Geoffrey S Baer Journal: PLoS One Date: 2021-11-10 Impact factor: 3.240
Authors: Branco S van Minnen; Albert J van der Veen; Sebastiaan A W van de Groes; Nico J J Verdonschot; Tony G van Tienen Journal: J Exp Orthop Date: 2022-09-07