Tomomasa Nakamura1,2, Monica A Linde1, Brandon D Marshall3, Hideyuki Koga2, Takeshi Muneta2,4, Patrick Smolinski1,3, Freddie H Fu5,6. 1. Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, Suite 1011, Pittsburgh, PA, 15213, USA. 2. Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan. 3. Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, PA, USA. 4. Department of Orthopaedic Surgery, National Hospital Organization Disaster Medical Center, Tokyo, Japan. 5. Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, Suite 1011, Pittsburgh, PA, 15213, USA. ffu@upmc.edu. 6. Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, PA, USA. ffu@upmc.edu.
Abstract
PURPOSE: The aim of this study was to evaluate the effects of knee biomechanics with an irreparable lateral meniscus defect using the centralization capsular meniscus support procedure in the setting of the ACL-reconstructed knee in a porcine model. The hypothesis is the arthroscopic centralization will decrease the laxity and rotation of the ACL-reconstructed knee. METHODS: Twelve fresh-frozen porcine knees were tested using a robotic testing system under the following loading conditions: (a) an 89.0 N anterior tibial load; (b) 4.0 N m internal and external rotational torques. Anatomic single-bundle ACL reconstruction with a 7 mm-diameter bovine extensor tendon graft was performed. A massive, middle segment, lateral meniscus defect was created via arthroscopy, and arthroscopic centralization was performed with a 1.4 mm anchor with a #2 suture. The LM states with ACL reconstruction evaluated were: intact, massive middle segment defect and with the lateral meniscus centralization procedure. RESULTS: The rotation of the ACL reconstructed knee with the lateral meniscus defect was significantly higher than with the centralized lateral meniscus under an external rotational torque at 30° of knee flexion, and under an internal rotational torque at 30° and 45° of knee flexion. There were no systematic and consistent effects of LM centralization under anterior tibial translation. CONCLUSIONS: In this porcine model, the capsular support of middle segment of the lateral meniscus using arthroscopic centralization improved the residual rotational laxity of the ACL-reconstructed knee accompanied with lateral meniscus dysfunction due to massive meniscus defect. This study quantifies the benefit to knee kinematics of arthroscopic centralization by restoring the lateral meniscal function.
PURPOSE: The aim of this study was to evaluate the effects of knee biomechanics with an irreparable lateral meniscus defect using the centralization capsular meniscus support procedure in the setting of the ACL-reconstructed knee in a porcine model. The hypothesis is the arthroscopic centralization will decrease the laxity and rotation of the ACL-reconstructed knee. METHODS: Twelve fresh-frozen porcine knees were tested using a robotic testing system under the following loading conditions: (a) an 89.0 N anterior tibial load; (b) 4.0 N m internal and external rotational torques. Anatomic single-bundle ACL reconstruction with a 7 mm-diameter bovine extensor tendon graft was performed. A massive, middle segment, lateral meniscus defect was created via arthroscopy, and arthroscopic centralization was performed with a 1.4 mm anchor with a #2 suture. The LM states with ACL reconstruction evaluated were: intact, massive middle segment defect and with the lateral meniscus centralization procedure. RESULTS: The rotation of the ACL reconstructed knee with the lateral meniscus defect was significantly higher than with the centralized lateral meniscus under an external rotational torque at 30° of knee flexion, and under an internal rotational torque at 30° and 45° of knee flexion. There were no systematic and consistent effects of LM centralization under anterior tibial translation. CONCLUSIONS: In this porcine model, the capsular support of middle segment of the lateral meniscus using arthroscopic centralization improved the residual rotational laxity of the ACL-reconstructed knee accompanied with lateral meniscus dysfunction due to massive meniscus defect. This study quantifies the benefit to knee kinematics of arthroscopic centralization by restoring the lateral meniscal function.
Authors: Volker Musahl; Musa Citak; Padhraig F O'Loughlin; Daniel Choi; Asheesh Bedi; Andrew D Pearle Journal: Am J Sports Med Date: 2010-06-08 Impact factor: 6.202
Authors: Richard Kijowski; Michael A Woods; Timothy A McGuine; John J Wilson; Ben K Graf; Arthur A De Smet Journal: Radiology Date: 2011-02-17 Impact factor: 11.105