H Wang1, T Chen1, A O Gee2, I D Hutchinson3, K Stoner4, R F Warren5, S A Rodeo5, S A Maher6. 1. Department of Biomechanics, Hospital for Special Surgery, 535 E 70st St., New York, NY 10021, USA. 2. Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 E 70st St., New York, NY 10021, USA; Orthopaedics and Sports Medicine, University of Washington School of Medicine, 535 E 70st St., New York, NY 10021, USA. 3. Department of Biomechanics, Hospital for Special Surgery, 535 E 70st St., New York, NY 10021, USA; Orthopaedic Surgery, Wake Forest School of Medicine, 535 E 70st St., New York, NY 10021, USA. 4. Department of Biomechanics, Hospital for Special Surgery, 535 E 70st St., New York, NY 10021, USA; Department of Biomedical Engineering, University of Iowa, 535 E 70st St., New York, NY 10021, USA. 5. Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 E 70st St., New York, NY 10021, USA. 6. Department of Biomechanics, Hospital for Special Surgery, 535 E 70st St., New York, NY 10021, USA. Electronic address: mahers@hss.edu.
Abstract
OBJECTIVE: To quantify the changes in regional dynamic loading patterns on tibial articular cartilage during simulated walking following medial meniscectomy and meniscal transplantation. METHODS: Seven fresh frozen human cadaveric knees were tested under multidirectional loads mimicking the activity of walking, while the contact stresses on the tibial plateau were synchronously recorded using an electronic sensor. Each knee was tested for three conditions: intact meniscus, medial meniscectomy, and meniscal transplantation. The loading profiles at different locations were assessed and common loading patterns were identified at different sites of the tibial plateau using an established numerical algorithm. RESULTS: Three regional patterns were found on the tibial plateau of intact knees. Following medial meniscectomy, the area of the first pattern which was located at the posterior aspect of the medial plateau was significantly reduced, while the magnitude of peak load was significantly increased by 120%. The second pattern which was located at the central-posterior aspects of the lateral plateau shifted anteriorly and laterally without changing its magnitude. The third pattern in the cartilage-to-cartilage contact region of the medial plateau was absent following meniscectomy. Meniscal transplantation largely restored the first pattern, but it did not restore the other two patterns. CONCLUSION: There are site-dependent changes in regional loading patterns on both the medial and lateral tibial plateau following medial meniscectomy. Even when a meniscal autograft is used where the geometry and material properties are kept constant, the only region in which the loading pattern is restored is at posterior aspect of the medial plateau.
OBJECTIVE: To quantify the changes in regional dynamic loading patterns on tibial articular cartilage during simulated walking following medial meniscectomy and meniscal transplantation. METHODS: Seven fresh frozen human cadaveric knees were tested under multidirectional loads mimicking the activity of walking, while the contact stresses on the tibial plateau were synchronously recorded using an electronic sensor. Each knee was tested for three conditions: intact meniscus, medial meniscectomy, and meniscal transplantation. The loading profiles at different locations were assessed and common loading patterns were identified at different sites of the tibial plateau using an established numerical algorithm. RESULTS: Three regional patterns were found on the tibial plateau of intact knees. Following medial meniscectomy, the area of the first pattern which was located at the posterior aspect of the medial plateau was significantly reduced, while the magnitude of peak load was significantly increased by 120%. The second pattern which was located at the central-posterior aspects of the lateral plateau shifted anteriorly and laterally without changing its magnitude. The third pattern in the cartilage-to-cartilage contact region of the medial plateau was absent following meniscectomy. Meniscal transplantation largely restored the first pattern, but it did not restore the other two patterns. CONCLUSION: There are site-dependent changes in regional loading patterns on both the medial and lateral tibial plateau following medial meniscectomy. Even when a meniscal autograft is used where the geometry and material properties are kept constant, the only region in which the loading pattern is restored is at posterior aspect of the medial plateau.
Authors: Sally Arno; Scott Hadley; Kirk A Campbell; Christopher P Bell; Michael Hall; Luis S Beltran; Michael P Recht; Orrin H Sherman; Peter S Walker Journal: Am J Sports Med Date: 2012-11-13 Impact factor: 6.202
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: Susannah Gilbert; Tony Chen; Ian D Hutchinson; Dan Choi; Clifford Voigt; Russell F Warren; Suzanne A Maher Journal: J Biomech Date: 2013-11-16 Impact factor: 2.712
Authors: Jin Goo Kim; Yong Seuk Lee; Tae Soo Bae; Jeong Ku Ha; Dong Hoon Lee; Young Jae Kim; Ho Jong Ra Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-09-07 Impact factor: 4.342
Authors: Hongsheng Wang; Tony Chen; Matthew F Koff; Ian D Hutchinson; Susannah Gilbert; Dan Choi; Russell F Warren; Scott A Rodeo; Suzanne A Maher Journal: J Biomech Date: 2014-04-16 Impact factor: 2.712