Measurement of meniscofemoral contact pressure after repair of bucket-handle tears with biodegradable implants
- Roland BeckerAffiliated withDepartment of Orthopaedic Surgery, Otto von Guericke University Email author
- , Dieter WirzAffiliated withLaboratory of Orthopaedic Biomechanics, University of Basel
- , Cornelius WolfAffiliated withDepartment of Orthopaedic Surgery, District Hospital
- , Beat GöpfertAffiliated withLaboratory of Orthopaedic Biomechanics, University of Basel
- , Wolfgang NebelungAffiliated withDepartment of Orthopaedic Surgery, Marien Hospital
- , Niklaus FriederichAffiliated withDepartment of Orthopaedic Surgery, Kantonsspital
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Biodegradable implants are frequently used for meniscus repair. Articular cartilage damage has been reported recently after meniscus repair with biodegradable implants. The aim of the study was to investigate the meniscofemoral contact pressure at the posterior horn of the medial and lateral meniscus after repair of bucket-handle lacerations.
Materials and methods
Specimens were mounted in a materials testing machine (Bionix 858, MTS) which was equipped with a load cell. The quadriceps tendon was attached to a hydraulic cylinder, and knee motion was controlled via tension of the quadriceps tendon. A piezo-resistive system (Tekscan, Boston, MA, USA) measured the meniscofemoral contact pressure. Five different types of biodegradable implants (Arrow, Dart, Fastener, Stinger and Meniscal Screw) and horizontal suture (no. 2 Ethibond) were tested. The knee was extended from 90° of flexion to 0° under a constant load of 350 N due to adjustment of the tension force of the quadriceps tendon. The femorotibial pressure and contact area were recorded at 0°, 30°, 60° and 90° of flexion.
The meniscofemoral pressure did not increase after meniscus repair with biodegradable implants or sutures. The meniscofemoral peak pressure at the posterior horn was 1.46±1.54 MPa in the medial compartment and 1.08±1.17 MPa in the lateral compartment at full knee extension. The meniscofemoral pressure increased significantly in both compartments with knee flexion from 0° to 90°.
Biodegradable implants for meniscus repair do not affect the meniscofemoral pressure. However, there remains a risk of damage to the cartilage when barbed implants are used. If the implant is not entirely advanced into the meniscus, the sharp head or some of the barbs at the column of the implant may come into direct contact with the articular cartilage of the femoral condyle or tibial plateau. The authors presume that incorrect positioning of the implant seems to be the major reason for cartilage damage.
KeywordsBiodegradable implant Meniscus repair Meniscofemoral pressure
- Measurement of meniscofemoral contact pressure after repair of bucket-handle tears with biodegradable implants
Archives of Orthopaedic and Trauma Surgery
Volume 125, Issue 4 , pp 254-260
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- Print ISSN
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- Biodegradable implant
- Meniscus repair
- Meniscofemoral pressure
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- Author Affiliations
- 1. Department of Orthopaedic Surgery, Otto von Guericke University, Leipziger Strasse 45, 39120, Magdeburg, Germany
- 2. Laboratory of Orthopaedic Biomechanics, University of Basel, Basel, Switzerland
- 3. Department of Orthopaedic Surgery, District Hospital, Mühlhausen, Germany
- 4. Department of Orthopaedic Surgery, Marien Hospital, Düsseldorf, Germany
- 5. Department of Orthopaedic Surgery, Kantonsspital, Bruderholz, Switzerland