Yuta Tachibana1, Tatsuo Mae2, Hiromichi Fujie3, Konsei Shino4, Tomoki Ohori2, Hideki Yoshikawa2, Ken Nakata2. 1. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, 565-0871, Japan. tachibanayuta@gmail.com. 2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, 565-0871, Japan. 3. Biomechanics Laboratory, Faculty of System Design, Tokyo Metropolitan University, 1-1, Minami-Osawa, Hachioji-city, Tokyo, 192-0397, Japan. 4. Sports Orthopaedic Surgery Center, Osaka Yukioka Hospital, 2-2-3, Ukita, Kita-ku, Osaka, 530-0021, Japan.
Abstract
PURPOSE: To clarify the effect of the radial tear of the lateral meniscus on the in situ meniscus force and the tibiofemoral relationship under axial loads and valgus torques. METHODS: Ten intact porcine knees were settled to a 6-degree of freedom robotic system, while the force and 3-dimensional path of the knees were recorded via Universal Force Sensor (UFS) during 3 cycles of 250-N axial load and 5-Nm valgus torque at 15°, 30°, 45°, and 60° of knee flexion. The same examination was performed on the following 3 meniscal states sequentially; 33, 66, and 100% width of radial tears at the middle segment of the lateral meniscus, while recording the force and path of the knees via UFS. Finally, all paths were reproduced after total lateral meniscectomy and the in situ force of the lateral meniscus were calculated with the principle of superposition. RESULTS: The radial tear of 100% width significantly decreased the in situ force of the lateral meniscus and caused tibial medial shift and valgus rotation at 30°-60° of knee flexion in both testing protocols. Under a 250-N axial load at 60° of knee flexion, the in situ force decreased to 36 ± 29 N with 100% width of radial tear, which was 122 ± 38 N in the intact state. Additionally, the tibia shifted medially by 2.1 ± 0.9 mm and valgusrotated by 2.5 ± 1.9° with the complete radial tear. However, the radial tear of 33 or 66% width had little effect on either the in situ force or the tibial position. CONCLUSION: A radial tear of 100% width involving the rim significantly decreased the in situ force of the lateral meniscus and caused medial shift and valgus rotation of the tibia, whereas a radial tear of up to 66% width produced only little change. The clinical relevance is that loss of meniscal functions due to complete radial tear can lead to abnormal stress concentration in a focal area of cartilage and can increase the risk of osteoarthritis in the future.
PURPOSE: To clarify the effect of the radial tear of the lateral meniscus on the in situ meniscus force and the tibiofemoral relationship under axial loads and valgus torques. METHODS: Ten intact porcine knees were settled to a 6-degree of freedom robotic system, while the force and 3-dimensional path of the knees were recorded via Universal Force Sensor (UFS) during 3 cycles of 250-N axial load and 5-Nm valgus torque at 15°, 30°, 45°, and 60° of knee flexion. The same examination was performed on the following 3 meniscal states sequentially; 33, 66, and 100% width of radial tears at the middle segment of the lateral meniscus, while recording the force and path of the knees via UFS. Finally, all paths were reproduced after total lateral meniscectomy and the in situ force of the lateral meniscus were calculated with the principle of superposition. RESULTS: The radial tear of 100% width significantly decreased the in situ force of the lateral meniscus and caused tibial medial shift and valgus rotation at 30°-60° of knee flexion in both testing protocols. Under a 250-N axial load at 60° of knee flexion, the in situ force decreased to 36 ± 29 N with 100% width of radial tear, which was 122 ± 38 N in the intact state. Additionally, the tibia shifted medially by 2.1 ± 0.9 mm and valgusrotated by 2.5 ± 1.9° with the complete radial tear. However, the radial tear of 33 or 66% width had little effect on either the in situ force or the tibial position. CONCLUSION: A radial tear of 100% width involving the rim significantly decreased the in situ force of the lateral meniscus and caused medial shift and valgus rotation of the tibia, whereas a radial tear of up to 66% width produced only little change. The clinical relevance is that loss of meniscal functions due to complete radial tear can lead to abnormal stress concentration in a focal area of cartilage and can increase the risk of osteoarthritis in the future.
Entities:
Keywords:
6-degree of freedom robotic system; In situ force; Lateral meniscus; Porcine knee; Radial tear; Tibiofemoral relationship
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