nach oben

International Orthopaedics

Erschienen in:

01.04.2015 | Original Paper

The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee

verfasst von: Olaf Lorbach, Matthias Kieb, Mirco Herbort, Imke Weyers, Michael Raschke, Martin Engelhardt

Erschienen in: International Orthopaedics | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The purpose of this study was the evaluation of knee laxity in the ACL-deficient knee with combined meniscal tear, meniscal suture and partial medial meniscectomy.

Methods

Kinematics of the intact knee were determined in 18 human cadaver specimens in response to a 134-N anterior tibial load (aTT) as well as a combined rotatory load of 10 Nm valgus and 4 Nm internal tibial rotation using a robotic/universal force moment sensor testing system. The anterior cruciate ligament was resected. Subsequently, a vertical bucket-handle medial meniscal tear was created followed by a standard meniscus repair using horizontal inside-out stitches or a partial medial meniscectomy. Knee kinematics were calculated following every sub-step.

Results

A significant increase of anterior tibial translation was found in the ACL-deficient knee compared to the intact knee at 30° and 90° of flexion (p = 0.001; p ≤ 0.001). Additional tear of the medial meniscus significantly increased anterior tibial translation (p = 0.01). In response to a simulated pivot shift, anterior tibial translation of the intact knee did not increase significantly after ACL resection (p = 0.067). However, ACL deficiency with an additional medial meniscus tear led to a significant increase compared to the intact knee at 0° of flexion (p = 0.009).

Conclusions

Additional injury of the medial meniscus increased aTT as well as aTT under a combined rotatory load in the ACL-deficient knee whereas repair of the meniscus significantly decreased aTT.

Therefore, the meniscus status does have a significant impact on knee kinematics in the ACL-deficient knee. The present biomechanical study further highlights the importance of preserving the meniscus especially in patients with additional ACL injuries.

Ahmed AM, Burke DL (1983) In-vitro measurement of static pressure distribution in synovial joints–Part I: tibial surface of the knee. J Biomech Eng 105:216–225CrossRefPubMed

Ghosh P, Taylor TK (1987) The knee joint meniscus. A fibrocartilage of some distinction. Clin Orthop Relat Res 224:52–63PubMed

Li X, Xu CP, Song JQ, Jiang N, Yu B (2013) Single-bundle versus double-bundle anterior cruciate ligament reconstruction: an up-to-date meta-analysis. Int Orthop 37:213–226CrossRefPubMedCentralPubMed

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 18:109–115CrossRefPubMed

Levy IM, Torzilli PA, Warren RF (1982) The effect of medial meniscectomy on anterior-posterior motion of the knee. J Bone Joint Surg Am 64:883–888PubMed

Thompson WO, Fu FH (1993) The meniscus in the cruciate-deficient knee. Clin Sports Med 12:771–796PubMed

Johnson RJ, Kettelkamp DB, Clark W, Leaverton P (1974) Factors effecting late results after meniscectomy. J Bone Joint Surg Am 56:719–729PubMed

Spang JT, Dang AB, Mazzocca A et al (2010) The effect of medial meniscectomy and meniscal allograft transplantation on knee and anterior cruciate ligament biomechanics. Arthroscopy 26:192–201CrossRefPubMed

Markolf KL, Kochan A, Amstutz HC (1984) Measurement of knee stiffness and laxity in patients with documented absence of the anterior cruciate ligament. J Bone Joint Surg Am 66:242–252PubMed

10.

Wang CJ, Walker PS (1974) Rotatory laxity of the human knee joint. J Bone Joint Surg Am 56:161–170PubMed

11.

Watanabe Y, Scyoc AV, Tsuda E, Debski RE, Woo SL (2004) Biomechanical function of the posterior horn of the medial meniscus: a human cadaveric study. J Orthop Sci 9:280–284CrossRefPubMed

12.

Papageorgiou CD, Gil JE, Kanamori A, Fenwick JA, Woo SL, Fu FH (2001) The biomechanical interdependence between the anterior cruciate ligament replacement graft and the medial meniscus. Am J Sports Med 29:226–231PubMed

13.

Furumatsu T, Miyazawa S, Tanaka T, Okada Y, Fujii M, Ozaki T (2014) Postoperative change in medial meniscal length in concurrent all-inside meniscus repair with anterior cruciate ligament reconstruction. Int Orthop 38:1393–1399CrossRefPubMed

14.

Markolf KL, Jackson SR, McAllister DR (2012) Force measurements in the medial meniscus posterior horn attachment: effects of anterior cruciate ligament removal. Am J Sports Med 40:332–338CrossRefPubMed

15.

Fithian DC, Paxton EW, Stone ML et al (2005) Prospective trial of a treatment algorithm for the management of the anterior cruciate ligament-injured knee. Am J Sports Med 33:335–346CrossRefPubMed

16.

Meunier A, Odensten M, Good L (2007) Long-term results after primary repair or non-surgical treatment of anterior cruciate ligament rupture: a randomized study with a 15-year follow-up. Scand J Med Sci Sports 17:230–237PubMed

17.

Levy AS, Meier SW (2003) Approach to cartilage injury in the anterior cruciate ligament-deficient knee. Orthop Clin N Am 34:149–167CrossRef

18.

Chhadia AM, Inacio MC, Maletis GB, Csintalan RP, Davis BR, Funahashi TT (2011) Are meniscus and cartilage injuries related to time to anterior cruciate ligament reconstruction? Am J Sports Med 39:1894–1899CrossRefPubMed

19.

Struewer J, Ziring E, Frangen TM et al (2013) Clinical outcome and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using hamstring graft: follow-up after 2 and 10 years. Int Orthop 37:271–277CrossRefPubMedCentralPubMed

20.

Noyes FR, Barber-Westin SD (2012) Treatment of meniscus tears during anterior cruciate ligament reconstruction. Arthroscopy 28:123–130CrossRefPubMed

21.

Melton JT, Murray JR, Karim A, Pandit H, Wandless F, Thomas NP (2011) Meniscal repair in anterior cruciate ligament reconstruction: a long-term outcome study. Knee Surg Sports Traumatol Arthrosc 19:1729–1734CrossRefPubMed

22.

Trojani C, Sbihi A, Djian P et al (2011) Causes for failure of ACL reconstruction and influence of meniscectomies after revision. Knee Surg Sports Traumatol Arthrosc 19:196–201CrossRefPubMed

23.

Lee SJ, Aadalen KJ, Malaviya P et al (2006) Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med 34:1334–1344CrossRefPubMed

24.

Noyes FR, Barber-Westin SD (2000) Arthroscopic repair of meniscus tears extending into the avascular zone with or without anterior cruciate ligament reconstruction in patients 40 years of age and older. Arthroscopy 16:822–829CrossRefPubMed

25.

Herbort M, Lenschow S, Fu FH, Petersen W, Zantop T (2010) ACL mismatch reconstructions: influence of different tunnel placement strategies in single-bundle ACL reconstructions on the knee kinematics. Knee Surg Sports Traumatol Arthrosc 18:1551–1558CrossRefPubMed

26.

Zantop T, Herbort M, Raschke MJ, Fu FH, Petersen W (2007) The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med 35:223–227CrossRefPubMed

27.

Amis AA, Scammell BE (1993) Biomechanics of intra-articular and extra-articular reconstruction of the anterior cruciate ligament. J Bone Joint Surg (Br) 75:812–817

28.

Chhabra A, Kline AJ, Nilles KM, Harner CD (2006) Tunnel expansion after anterior cruciate ligament reconstruction with autogenous hamstrings: a comparison of the medial portal and transtibial techniques. Arthroscopy 22:1107–1112CrossRefPubMed

29.

Jordan SS, DeFrate LE, Nha KW, Papannagari R, Gill TJ, Li G (2007) The in vivo kinematics of the anteromedial and posterolateral bundles of the anterior cruciate ligament during weightbearing knee flexion. Am J Sports Med 35:547–554CrossRefPubMed

30.

Kanamori A, Zeminski J, Rudy TW, Li G, Fu FH, Woo SL (2002) The effect of axial tibial torque on the function of the anterior cruciate ligament: a biomechanical study of a simulated pivot shift test. Arthroscopy 18:394–398CrossRefPubMed

31.

Lenschow S, Zantop T, Weimann A et al (2006) Joint kinematics and in situ forces after single bundle PCL reconstruction: a graft placed at the center of the femoral attachment does not restore normal posterior laxity. Arch Orthop Trauma Surg 126:253–259CrossRefPubMed

32.

Buoncristiani AM, Tjoumakaris FP, Starman JS, Ferretti M, Fu FH (2006) Anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 22:1000–1006CrossRefPubMed

33.

Daniel DM, Stone ML, Sachs R, Malcom L (1985) Instrumented measurement of anterior knee laxity in patients with acute anterior cruciate ligament disruption. Am J Sports Med 13:401–407CrossRefPubMed

34.

Schulze M, Hartensuer R, Gehweiler D, Holscher U, Raschke MJ, Vordemvenne T (2012) Evaluation of a robot-assisted testing system for multisegmental spine specimens. J Biomech 45:1457–1462CrossRefPubMed

35.

Becker R, Mauer C, Starke C et al (2013) Anteroposterior and rotational stability in fixed and mobile bearing unicondylar knee arthroplasty: a cadaveric study using the robotic force sensor system. Knee Surg Sports Traumatol Arthrosc 21:2427–2432CrossRefPubMed

36.

Papannagari R, Gill TJ, DeFrate LE, Moses JM, Petruska AJ, Li G (2006) In vivo kinematics of the knee after anterior cruciate ligament reconstruction: a clinical and functional evaluation. Am J Sports Med 34:2006–2012CrossRefPubMed

37.

Musahl V, Citak M, O’Loughlin PF, Choi D, Bedi A, Pearle AD (2010) The effect of medial versus lateral meniscectomy on the stability of the anterior cruciate ligament-deficient knee. Am J Sports Med 38:1591–1597CrossRefPubMed

38.

Seon JK, Gadikota HR, Kozanek M, Oh LS, Gill TJ, Li G (2009) The effect of anterior cruciate ligament reconstruction on kinematics of the knee with combined anterior cruciate ligament injury and subtotal medial meniscectomy: an in vitro robotic investigation. Arthroscopy 25:123–130CrossRefPubMedCentralPubMed

39.

Bedi A, Musahl V, O’Loughlin P et al (2010) A comparison of the effect of central anatomical single-bundle anterior cruciate ligament reconstruction and double-bundle anterior cruciate ligament reconstruction on pivot-shift kinematics. Am J Sports Med 38:1788–1794CrossRefPubMed

40.

Ahn JH, Bae TS, Kang KS, Kang SY, Lee SH (2011) Longitudinal tear of the medial meniscus posterior horn in the anterior cruciate ligament-deficient knee significantly influences anterior stability. Am J Sports Med 39:2187–2193CrossRefPubMed

41.

Smith JP III, Barrett GR (2001) Medial and lateral meniscal tear patterns in anterior cruciate ligament-deficient knees. A prospective analysis of 575 tears. Am J Sports Med 29:415–419PubMed

42.

Arno S, Hadley S, Campbell KA et al (2013) The effect of arthroscopic partial medial meniscectomy on tibiofemoral stability. Am J Sports Med 41:73–79CrossRefPubMed

Titel: The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee
verfasst von: Olaf Lorbach
Matthias Kieb
Mirco Herbort
Imke Weyers
Michael Raschke
Martin Engelhardt
Publikationsdatum: 01.04.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 4/2015
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-014-2581-x

Arthropedia

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

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

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

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2015

Clinical outcome and return to work following single-stage combined autologous chondrocyte implantation and high tibial osteotomy

Primary cementless hip arthroplasty as a potential risk factor for non-union after long-stem revision arthroplasty in periprosthetic femoral fractures

A nationwide analysis of risk factors for in-hospital myocardial infarction after total joint arthroplasty

Comparison of resorption and remodeling of bioabsorbable interference screws in anterior cruciate ligament reconstruction

Surgical management of Achilles tendon re-ruptures: a prospective cohort study