S Zaffagnini1,2,3, C Signorelli4, T Bonanzinga1,2, A Grassi1,2, H Galán5, I Akkawi1,2, L Bragonzoni1,3, F Cataldi6, M Marcacci1,2,3. 1. Laboratorio di Biomeccanica e Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, BO, Italy. 2. Clinica Ortopedica e Traumatologica I, Istituto Ortopedico Rizzoli, Bologna, BO, Italy. 3. Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, BO, Italy. 4. Laboratorio di Biomeccanica e Innovazione Tecnologica, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, BO, Italy. c.signorelli@biomec.ior.it. 5. Instituto Dr. Jaime Slullitel, Rosario, Santa Fe, Argentina. 6. Anestesia e terapia intensiva post operatoria e del dolore, Istituto Ortopedico Rizzoli, Bologna, BO, Italy.
Abstract
PURPOSE: The purpose of the present study was to determine, in vivo, the effect of different types of meniscectomy on an ACL-deficient knee. METHODS: Using a computer-assisted navigation system, 56 consecutive patients (45 men and 11 women) were subjected to a biomechanical testing with Lachman test (AP30), drawer test (AP90), internal/external rotation test, varus/valgus rotation test and pivot-shift test. The patients were divided into three groups according to the status of the medial meniscus. Group BH, 8 patients with bucket-handle tear of medial meniscus underwent a subtotal meniscectomy; Group PHB, 19 patients with posterior horn body of medial meniscus tear underwent a partial meniscectomy; and Group CG with isolated ACL rupture, as a control group, with 29 patients. RESULTS: A significant difference in anterior tibial translation was seen at 30 grades and in 90 grades between BH and PHB groups compared to the CG. In response to pivot-shift test, no significant differences in terms of AREA and POSTERIOR ACC were found among the three groups (n.s). Concerning the anterior displacement of the pivot shift a statistically significant differences among the three tested groups was found. CONCLUSION: The present study shows that meniscal defects significantly affect the kinematics of an ACL-deficient knee in terms of anterior tibial translation under static and dynamic testing.
PURPOSE: The purpose of the present study was to determine, in vivo, the effect of different types of meniscectomy on an ACL-deficient knee. METHODS: Using a computer-assisted navigation system, 56 consecutive patients (45 men and 11 women) were subjected to a biomechanical testing with Lachman test (AP30), drawer test (AP90), internal/external rotation test, varus/valgus rotation test and pivot-shift test. The patients were divided into three groups according to the status of the medial meniscus. Group BH, 8 patients with bucket-handle tear of medial meniscus underwent a subtotal meniscectomy; Group PHB, 19 patients with posterior horn body of medial meniscus tear underwent a partial meniscectomy; and Group CG with isolated ACL rupture, as a control group, with 29 patients. RESULTS: A significant difference in anterior tibial translation was seen at 30 grades and in 90 grades between BH and PHB groups compared to the CG. In response to pivot-shift test, no significant differences in terms of AREA and POSTERIOR ACC were found among the three groups (n.s). Concerning the anterior displacement of the pivot shift a statistically significant differences among the three tested groups was found. CONCLUSION: The present study shows that meniscal defects significantly affect the kinematics of an ACL-deficient knee in terms of anterior tibial translation under static and dynamic testing.
Entities:
Keywords:
ACL; Deficient knee; Laxity; Meniscectomy; Navigation system
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