Abstract
Purpose
The purpose of this study was to evaluate the effects of different types of lateral meniscus root tears in terms of tibiofemoral contact stress.
Methods
Ten porcine knees each underwent five different testing conditions with the menisci intact, a simulated lateral posterior root tear with and without cutting the meniscofemoral ligament and with an artificial tear of the posterior root of the medial meniscus. Biomechanical testing was performed at 30° of flexion with an axial load of 100 N. A pressure sensor (st Sensor Type S2042, Novel, Munich) was used to measure the tibiofemoral contact area and the tibiofemoral contact pressure. Data were analyzed to assess the differences in contact area and tibiofemoral peak contact pressure among the five meniscal conditions.
Results
There was no significant difference in mean contact pressure between the state with the menisci intact and an isolated posterior root tear of the lateral meniscus. In case of a root tear and a tear of the meniscofemoral ligament, the contact area decreased in comparison with the intact state of the menisci. After additional cutting of the meniscofemoral ligament, the tibiofemoral contact pressure was significantly higher in comparison with the intact state and the avulsion injury. In the medial compartment, joint compression forces were significantly increased in comparison with the intact state after cutting the posterior root of the medial meniscus (P < 0.05).
Conclusions
The consequence of a medial meniscus root tear is well known and was verified by this analysis. The results of the present study show that the biomechanical consequences of a lateral meniscus root tear depend on the state of the meniscofemoral ligament. An increase in tibiofemoral contact pressure is only to be expected in combined injuries of the meniscus root and the meniscofemoral ligaments.
Clinical relevance
Posterior lateral meniscus root tear might have a better prognosis in terms of the development of osteoarthritis when the meniscofemoral ligament is intact.
Similar content being viewed by others
References
Koenig JH, Ranawat AS, Umans HR, Difelice GS (2009) Meniscal root tears: diagnosis and treatment. Arthroscopy 25(9):1025–1032
Pagnani MJ, Cooper DE, Warren RF (1991) Extrusion of the medial meniscus. Arthroscopy 7:297–300
Bin SI, Kim JM, Shin SJ (2004) Radial tears of the posterior horn of the medial meniscus. Arthroscopy 20:373–378
Fukubayashi T, Kurosawa H (1980) The contact area and pressure distribution pattern of the knee. A study of normal and osteoarthrotic knee joints. Acta Orthop Scand 51:871–879
Petersen W, Tillmann B (1998) Collagenous fibril texture of the human knee joint menisci. Anat Embryol 197:317–324
Jones RS, Keene GC, Learmonth DJ et al (1996) Direct measurement of hoop strains in the intact and torn human medial meniscus. Clin Biomech 11:295–300
McDermott ID, Amis AA (2006) The consequences of meniscectomy. J Bone Jt Surg Br 88:1549–1556
Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Jt Surg Am 90:1922–1931
Kenny C (1997) Radial displacement of the medial meniscus and Fairbank’s signs. Clin Orthop Relat Res 339:163–173
Lerer DB, Umans HR, Hu MX, Jones MH (2004) The role of meniscal root pathology and radial meniscal tear in medial meniscal extrusion. Skeletal Radiol 33:569–574
Forkel P, Petersen W (2012) Posterior root tear fixation of the lateral meniscus combined with arthroscopic ACL double-bundle reconstruction: technical note of a transosseous fixation using the tibial PL tunnel. Arch Orthop Trauma Surg 132(3):387–391
Brody JM, Lin HM, Hulstyn MJ, Tung GA (2006) Lateral meniscus root tear and meniscus extrusion with anterior cruciate ligament tear. Radiology 239:805–810
West RV, Kim JG, Armfield D, Harner CD (2004) Lateral meniscal root tears associated with anterior cruciate ligament injury: classification and management (SS-70). Arthroscopy 20:e32–e33
Petersen W, Zantop T (2006) Avulsion injury to the posterior horn of the lateral meniscus. Technique for arthroscopic refixation. Unfallchirurg (German) 109(11):984–987
Seo JH, Li G, Shetty GM, Kim JH, Bae JH, Jo ML, Kim JS, Lee SJ, Nha KW (2009) Effect of repair of radial tears at the root of the posterior horn of the medial meniscus with the pullout suture technique: a biomechanical study using porcine knees. Arthroscopy 25(11):1281–1287
Pothast W, Lersch C, Segesser B, Koebke J, Bruggemann GP (2008) Intraarticular pressure distribution in the talocrural joint is related to lower leg muscle forces. Clin Biomech 23:632–639
Martinelli L, Hurschler C, Rosenbaum D (2006) Comparison of capacitive versus resistive joint contact stress sensors. Clin Orthop Relat Res 447:214–220
Herbort M, Zelle S, Rosenbaum D, Osada N, Raschke M, Petersen W, Zantop T (2011) Arthroscopic fixation of matrix-associated autologous chondrocyte implantation: importance of fixation pin angle on joint compression forces. Arthroscopy 27(6):809–816
Ding C, Martel-Pelletier J, Pelletier JP et al (2007) Knee meniscal extrusion in a largely non-osteoarthritic cohort: association with greater loss of cartilage volume. Arthr Res Ther 9:R21
Robertson DD, Armfield DR, Towers JD, Maloney WJ, Harner CD (2009) Meniscal root injury and spontaneous osteonecrosis of the knee: an observation. J Bone Jt Surg [Br] 91(2):190–195
Shelbourne KD, Roberson TA, Gray T (2011) Long-term evaluation of posterior lateral meniscus root tears left in situ at the time of anterior cruciate ligament reconstruction. Am J Sports Med 39(7):1439–1443
Ahn JH, Lee YS, Yoo JC, Chang MJ, Park SJ, Pae YR (2010) Results of arthroscopic all-inside repair for lateral meniscus root tear in patients undergoing concomitant anterior cruciate ligament reconstruction. Arthroscopy 26(1):67–75
Ahn JH, Lee YS, Chang JY, Chang MJ, Eun SS, Kim SM (2009) Arthroscopic all inside repair of the lateral meniscus root tear. Knee 16:77–80
Petersen W, Tillmann B (1995) Age-related blood and lymph supply of the knee menisci. A cadaver study. Acta Orthop Scand 66(4):308–312
Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Jt Surg Am 30:664–670
Amadi HO, Gupte CM, Lie DT, McDermott ID, Amis AA, Bull AM (2008) A biomechanical study of the meniscofemoral ligaments and their contribution to contact pressure reduction in the knee. Knee Surg Sports Traumatol Arthrosc 16(11):1004–1008
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Forkel, P., Herbort, M., Schulze, M. et al. Biomechanical consequences of a posterior root tear of the lateral meniscus: stabilizing effect of the meniscofemoral ligament. Arch Orthop Trauma Surg 133, 621–626 (2013). https://doi.org/10.1007/s00402-013-1716-7
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-013-1716-7