Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 11/2016

01.07.2016 | Knee

Does meniscus removal affect ACL-deficient knee laxity? An in vivo study

verfasst von: S. Zaffagnini, C. Signorelli, T. Bonanzinga, A. Grassi, H. Galán, I. Akkawi, L. Bragonzoni, F. Cataldi, M. Marcacci

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 11/2016

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Ahn JH, Bae TS, Kang KS, Kang SY, Lee SH (2011) Longitudinal tear of medial meniscus posterior horn in the anterior cruciate ligament-deficient knee significantly influences anterior stability. Am J Sports Med 39(10):2187–2193CrossRefPubMed Ahn JH, Bae TS, Kang KS, Kang SY, Lee SH (2011) Longitudinal tear of medial meniscus posterior horn in the anterior cruciate ligament-deficient knee significantly influences anterior stability. Am J Sports Med 39(10):2187–2193CrossRefPubMed
2.
Zurück zum Zitat Allen CR, Wong EK, Livesay GA, Sakane M, Fu FH, Woo SL (2000) Importance of the medial meniscus in the anterior cruciate ligament-deficient knee. J Orthop Res 18(1):109–115CrossRefPubMed Allen CR, Wong EK, Livesay GA, Sakane M, Fu FH, Woo SL (2000) Importance of the medial meniscus in the anterior cruciate ligament-deficient knee. J Orthop Res 18(1):109–115CrossRefPubMed
3.
Zurück zum Zitat Chen L, Linde-Rosen M, Hwang SC, Zhou J, Xie Q, Smolinsky P, Fu FH (2015) The effect of medial meniscal horn injury on knee stability. Knee Surg Sports Traumatol Arthrosc 23(1):126–131CrossRefPubMed Chen L, Linde-Rosen M, Hwang SC, Zhou J, Xie Q, Smolinsky P, Fu FH (2015) The effect of medial meniscal horn injury on knee stability. Knee Surg Sports Traumatol Arthrosc 23(1):126–131CrossRefPubMed
4.
Zurück zum Zitat Hanley ST, Warren RF (1987) Arthroscopy meniscectomy in the anterior cruciate ligament-deficient knee. Arthroscopy 3(1):59–65CrossRefPubMed Hanley ST, Warren RF (1987) Arthroscopy meniscectomy in the anterior cruciate ligament-deficient knee. Arthroscopy 3(1):59–65CrossRefPubMed
5.
Zurück zum Zitat Jakob RP, Staübli HU, Deland JT (1987) Grading the pivot shift. Objective test with implications to treatment. J Bone Jt Surg Br 69(2):294–299 Jakob RP, Staübli HU, Deland JT (1987) Grading the pivot shift. Objective test with implications to treatment. J Bone Jt Surg Br 69(2):294–299
6.
Zurück zum Zitat Kuroda R, Hoshino Y, Nagamune K (2008) Intraoperative measurement of pivot shift by electromagnetic sensors. Oper Tech Orthop 18(3):190–195CrossRef Kuroda R, Hoshino Y, Nagamune K (2008) Intraoperative measurement of pivot shift by electromagnetic sensors. Oper Tech Orthop 18(3):190–195CrossRef
7.
Zurück zum Zitat Levy IM, Torzilli PA, Gould JD, Warren RF (1989) The effect of lateral meniscectomy on motion of the knee. J Bone Jt Surg Am 71(3):401–406CrossRef Levy IM, Torzilli PA, Gould JD, Warren RF (1989) The effect of lateral meniscectomy on motion of the knee. J Bone Jt Surg Am 71(3):401–406CrossRef
8.
Zurück zum Zitat Levy IM, Torzilli PA, Warren RF (1982) The effect of medial meniscectomy on anterior-posterior motion of the knee. J Bone Jt Surg Am 64(6):883–888CrossRef Levy IM, Torzilli PA, Warren RF (1982) The effect of medial meniscectomy on anterior-posterior motion of the knee. J Bone Jt Surg Am 64(6):883–888CrossRef
9.
Zurück zum Zitat Lopomo N, Bignozzi S, Martelli S, Zaffagnini S, Iacono F, Visani A, Marcacci M (2009) Reliability of navigation system for intra-operative evaluation of antero-posterior knee joint laxity. Comput Biol Med 39(3):280–285CrossRefPubMed Lopomo N, Bignozzi S, Martelli S, Zaffagnini S, Iacono F, Visani A, Marcacci M (2009) Reliability of navigation system for intra-operative evaluation of antero-posterior knee joint laxity. Comput Biol Med 39(3):280–285CrossRefPubMed
10.
Zurück zum Zitat Lopomo N, Zaffagnini S, Bignozzi S, Visani A, Marcacci M (2010) Pivot-Shift test: analysis and quantification of knee laxity parameters usin navigation system. J Orthop Res 28(2):164–169PubMed Lopomo N, Zaffagnini S, Bignozzi S, Visani A, Marcacci M (2010) Pivot-Shift test: analysis and quantification of knee laxity parameters usin navigation system. J Orthop Res 28(2):164–169PubMed
11.
Zurück zum Zitat Lorbach O, Kieb M, Herbort M (2015) The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee. Int Orthop (SICOT) 39(4):681–687CrossRef Lorbach O, Kieb M, Herbort M (2015) The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee. Int Orthop (SICOT) 39(4):681–687CrossRef
12.
Zurück zum Zitat Lorbach O, Kieb M, Domnick C, Herbort M, Weyers I, Raschke M, Engelhardt M (2015) Biomechanical evaluation of knee kinematics after anatomic single- and anatomic double-bundle ACL reconstructions with medial meniscal repair. Knee Surg Sports Traumatol Arthrosc 23(9):2734–2741CrossRefPubMed Lorbach O, Kieb M, Domnick C, Herbort M, Weyers I, Raschke M, Engelhardt M (2015) Biomechanical evaluation of knee kinematics after anatomic single- and anatomic double-bundle ACL reconstructions with medial meniscal repair. Knee Surg Sports Traumatol Arthrosc 23(9):2734–2741CrossRefPubMed
13.
Zurück zum Zitat Martelli S, Lopomo N, Bignozzi S, Zaffagnini S, Visani A (2007) Validation of a new protocol for navigated intraoperative assesment of knee kinematics. Comput Biol Med 37(6):872–878CrossRefPubMed Martelli S, Lopomo N, Bignozzi S, Zaffagnini S, Visani A (2007) Validation of a new protocol for navigated intraoperative assesment of knee kinematics. Comput Biol Med 37(6):872–878CrossRefPubMed
14.
Zurück zum Zitat Musahl V, Citak M, O`Loughlin PF, Choi D, Bedi A, Paerle AD (2010) The effect of medial versus lateral meniscectomy on the stability of the anterior cruciate ligament-deficient knee. Am J Sports Med 38(8):1591–1597CrossRefPubMed Musahl V, Citak M, O`Loughlin PF, Choi D, Bedi A, Paerle AD (2010) The effect of medial versus lateral meniscectomy on the stability of the anterior cruciate ligament-deficient knee. Am J Sports Med 38(8):1591–1597CrossRefPubMed
15.
Zurück zum Zitat Papageorgiou CD, Gil JE, Kanamori A, Fenwick JA, Woo SL, Fu FH (2001) The biomechanical interdependence between the anterior cruciate replacement graft and the medial meniscus. Am J Sports Med 29(2):226–231PubMed Papageorgiou CD, Gil JE, Kanamori A, Fenwick JA, Woo SL, Fu FH (2001) The biomechanical interdependence between the anterior cruciate replacement graft and the medial meniscus. Am J Sports Med 29(2):226–231PubMed
16.
Zurück zum Zitat Rueff D, Nyland J, KocabeyY Chang HC, Caborn DN (2006) Self-reported patient outcomes at minimum of 5 years after allograft anterior cruciate ligament reconstruction with or without media meniscus transplantation: an age-, sex-, and activity leves matched comparison in patients aged approximately 50 years. Arthroscopy 22(10):1053–1062CrossRefPubMed Rueff D, Nyland J, KocabeyY Chang HC, Caborn DN (2006) Self-reported patient outcomes at minimum of 5 years after allograft anterior cruciate ligament reconstruction with or without media meniscus transplantation: an age-, sex-, and activity leves matched comparison in patients aged approximately 50 years. Arthroscopy 22(10):1053–1062CrossRefPubMed
17.
Zurück zum Zitat Seon JK, Gadikota HR, Kozanek M, Oh LS, Gill TJ, Li G (2009) The effect of anterior cruciate ligament reconstruction on kinematics knee with combined anterior cruciate ligament injury and subtotal medial meniscectomy: an in vitro robotic investigation. Arthroscopy 25(2):123–130CrossRefPubMed Seon JK, Gadikota HR, Kozanek M, Oh LS, Gill TJ, Li G (2009) The effect of anterior cruciate ligament reconstruction on kinematics knee with combined anterior cruciate ligament injury and subtotal medial meniscectomy: an in vitro robotic investigation. Arthroscopy 25(2):123–130CrossRefPubMed
18.
Zurück zum Zitat Shelbourne KD, Gray T (2000) Results of anterior cruciate ligament reconstruction based on meniscus and articular cartilage status at the time of surgery: five to Fifteen-years evaluations. Am J Sports Med 28(4):446–452PubMed Shelbourne KD, Gray T (2000) Results of anterior cruciate ligament reconstruction based on meniscus and articular cartilage status at the time of surgery: five to Fifteen-years evaluations. Am J Sports Med 28(4):446–452PubMed
19.
Zurück zum Zitat Shoemaker SC, Markolf KL (1986) The role of the meniscus in anterior-posterior stability of the loaded anterior cruciate-deficient knee. Effects of partial versus total meniscectomy. J Bone Jt Surg Am 68(1):71–79CrossRef Shoemaker SC, Markolf KL (1986) The role of the meniscus in anterior-posterior stability of the loaded anterior cruciate-deficient knee. Effects of partial versus total meniscectomy. J Bone Jt Surg Am 68(1):71–79CrossRef
20.
Zurück zum Zitat Smith JP 3rd, Barret GR (2001) Medial and lateral meniscal tear patterns in anterior cruciate ligament-deficient knees: a prospective analysis of 575 tears. Am J Sports Med 29(4):415–419PubMed Smith JP 3rd, Barret GR (2001) Medial and lateral meniscal tear patterns in anterior cruciate ligament-deficient knees: a prospective analysis of 575 tears. Am J Sports Med 29(4):415–419PubMed
21.
Zurück zum Zitat Spang JT, Dang ABC, Mazzocca A, Rincon L, Obopilwe E, Beynnon B, Arciero RA (2010) The effect of medial meniscectomy and meniscal allograft transplantation on knee and anterior cruciate ligament biomechanics. Arthroscopy 26(2):192–201CrossRefPubMed Spang JT, Dang ABC, Mazzocca A, Rincon L, Obopilwe E, Beynnon B, Arciero RA (2010) The effect of medial meniscectomy and meniscal allograft transplantation on knee and anterior cruciate ligament biomechanics. Arthroscopy 26(2):192–201CrossRefPubMed
22.
Zurück zum Zitat Wu WH, Hackett T, Richmond JC (2002) Effects of meniscal and articular surface status on knee stability, function, and symptoms after anterior cruciate ligament reconstruction: a long-term prospective study. Am J Sports Med 30(6):845–850PubMed Wu WH, Hackett T, Richmond JC (2002) Effects of meniscal and articular surface status on knee stability, function, and symptoms after anterior cruciate ligament reconstruction: a long-term prospective study. Am J Sports Med 30(6):845–850PubMed
23.
Zurück zum Zitat Zaffagnini S, Bignozzi S, Martelli S, Imakiire N, Lopomo N, Marcacci M (2006) New intraoperative protocol for kinematics evaluation of ACL reconstruction: preliminary results. Knee Surg Sports Traumatol Artrhrosc 14(9):811–816CrossRef Zaffagnini S, Bignozzi S, Martelli S, Imakiire N, Lopomo N, Marcacci M (2006) New intraoperative protocol for kinematics evaluation of ACL reconstruction: preliminary results. Knee Surg Sports Traumatol Artrhrosc 14(9):811–816CrossRef
Metadaten
Titel
Does meniscus removal affect ACL-deficient knee laxity? An in vivo study
verfasst von
S. Zaffagnini
C. Signorelli
T. Bonanzinga
A. Grassi
H. Galán
I. Akkawi
L. Bragonzoni
F. Cataldi
M. Marcacci
Publikationsdatum
01.07.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 11/2016
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4222-y

Weitere Artikel der Ausgabe 11/2016

Knee Surgery, Sports Traumatology, Arthroscopy 11/2016 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.