In vitro load transmission in the canine knee: The effect of medial meniscectomy and varus rotation

  • D. R. Anderson
  • A. P. Newman
  • A. U. Daniels
Article

Abstract

The purpose of this study was to determine the in vitro load-transmission characteristics of the canine knee, paying particular attention to the positioning effect of the meniscus in the coronal plane. The intact joint was first loaded and then tested under two different loading conditions after a complete medial meniscectomy. The first set of test conditions attempted to simulate those used by previous investigators, by ignoring the spacer effect of the meniscus. The second set of tests were carried ouf following varus rotation of the joint (to account for the loss of the meniscal spacer) to assure initial contact in both tibiofemoral compartments at the start of test cycle. It is presumed that this varus realignment occurs during weight bearing following meniscectomy in vivo. As in previous studies, the joints experienced slightly larger displacements (although not statistically significant) and had lower stiffness values following medial meniscectomy than when intact. However, following varus realignment of the joint after meniscectomy, the displacement was markedly smaller (−35% to −40%;P<0.01) and the structural stiffness was much greater (47–123%;P<0.05) over the range of forces analyzed, compared with the intact joint. The ratio of dissipated to input energy was 42% for the intact joint, and increased following meniscectomy to 54% (P<0.05) with realignment and 55% (P<0.05) without realignment. Measured contact area decreased by 17% (P<0.05) following meniscectomy alone, and by 12% (P<0.05) following meniscectomy with realignment. Scince varus rotation of the joint following meniscectomy resulted in an increase in structural stiffness, it was concluded that the medial meniscus reduces the structural stiffness of the intact joint. In addition, the meniscus has a role in elastic energy storage and increasing contact area. A model is presented to explain both the decrease in stiffness after meniscectomy without varus rotation and the increase in stiffness after meniscectomy with varus rotation, employing linear springs of unequal length and different stiffnesses. After removal of the softer meniscal element and allowing joint approximation to occur, loading of the stiffer articular element results in an initially stiffer preparation.

Key words

Meniscus Meniscctomy Varus Biomechanics Knee 
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References

  1. 1.
    Ahmed AM, Burke DL (1983) In vitro measurement of static pressure distribution in synovial joint.. I. Tibial surface of the knee. J Biomech Eng 105:216–225PubMedGoogle Scholar
  2. 2.
    Arnoczky SP, Warren RF (1983) The microvasculature of the meniscus and its response to injury. Am J Sports Med 11:131–141PubMedGoogle Scholar
  3. 3.
    Arnoczky SP, McDevitt CA, Schmidt MB, Mow VC, Warren RF (1988) The effect of cryopreservation on canine menisci: a biochemical, morphologic and biomechanical evaluation. J Orthop Res 6:1–12PubMedGoogle Scholar
  4. 4.
    Arnoczky SP, Waren RF, Spivak JM (1988) Meniscal repair using exogenous fibrin clot. An experimental study in dogs. J Bone Joint Surg [Am] 70:1209–1216Google Scholar
  5. 5.
    Aspden RM (1985) A model for the function and failure of the meniscus. Eng Med 14:119–122PubMedGoogle Scholar
  6. 6.
    Cabaud HE, Rodkey WG, Fitzwater JE (1981) Medial meniscus repairs: an experimental and morphologic study. Am J Sports Med 9:129–134PubMedGoogle Scholar
  7. 7.
    Canham W, Stanish W (1986) A study of the biological behaviour of the meniscus as a transplant in the medial compartment of a dog's knee. Am J Sports Med 14:376–379PubMedGoogle Scholar
  8. 8.
    Cargill AO'R, Jackson JP (1976) Bucket-handle tear of the medial meniscus. J Bone Joint Surg [Am] 58:248–251Google Scholar
  9. 9.
    Cassidy RE, Shaffer AJ (1981) Repair of peripheral meniscus tears. Am J Sports Med 9:209–214PubMedGoogle Scholar
  10. 10.
    DeHaven KE (1990) Decision-making factors in the treatment of meniscus lesions. Clin Orthop 252:49–54PubMedGoogle Scholar
  11. 11.
    Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Joint Surg [Br] 30:664–670Google Scholar
  12. 12.
    Fithian DC, Kelly MA, Mow VC (1990) Material properties and structure-function relationships in the menisci. Clin Orthop 252:19–31PubMedGoogle Scholar
  13. 13.
    Fukubayashi T, Kurosawa H (1980) The contact area and pressure distribution pattern of the knee. Acta Orthop Scand 51:871–879PubMedGoogle Scholar
  14. 14.
    Gershuni DH, Skyhar MJ, Danzig LA, Camp J, Hargens AR, Akeson WH (1989) Experimental models to promote healing of tears in the avascular segment of canine knee menisci. J Bone Joint Surg [Am] 71:1361–1370Google Scholar
  15. 15.
    Grood ES (1984) Meniscal function. Adv Orthop Surg 7:193–197Google Scholar
  16. 16.
    Hamberg P, Gillquist J, Lysholm J (1983) Suture of new and old peripheral meniscus tears. J Bone Joint Surg [Am] 65:193–197Google Scholar
  17. 17.
    Henning CE, Lynch MA, Yearout IKM, Vequist SW, Stallbaumer RJ, Decker KA (1990) Arthroscopic meniscal repair using exogenous fibrin clot. Clin Orthop 252:64–72PubMedGoogle Scholar
  18. 18.
    Huberti HH, Hayes WC (1984) Patellofemoral contact pressures. J Bone Joint Surg 5:715–724Google Scholar
  19. 19.
    Inaba HI, Arai MA, Watanabe WW (1990) Influence of the varus-valgus instability on the contact of the femoro-tibial joint. Proc Inst Mech Eng [H] 204:61–64Google Scholar
  20. 20.
    Johnson RJ, Kettelkamp DB, Clark W, Leaverton P (1974) Factors effecting late results after meniscectomy. J Bone Joint Surg [Am] 56:719–729Google Scholar
  21. 21.
    Kenny C, Krackow KA, McCarthy EF (1983) An evaluation of a silastic meniscus prosthesis of post-meniscectomy osteoarthritis. Trans Orthop Res Soc 8:335Google Scholar
  22. 22.
    Kettelkamp DB, Jacobs AW (1972) Tibiofemoral contact area —determination and implications. J Bone Joint Surg [Am] 54:349–356Google Scholar
  23. 23.
    Kostuik JP, Oswald S, Harris WR, Woolridge C (1975) A study of weight transmission through the knee joint with applied varus and valgus loads. Clin Orthop 108:95–98PubMedGoogle Scholar
  24. 24.
    Krause WR, Pope MH, Johnson RJ, Wilder DG (1976) Mechanical changes in the knee after meniscectomy. J Bone Joint Surg [Am] 58:599–604Google Scholar
  25. 25.
    Kurosawa H, Fukubayashi T, Nakajima H (1980) Load-bearing mode of the knee joint: physical behavior of the knee joint with or without menisci. Clin Orthop 1:283–290Google Scholar
  26. 26.
    Lutfi AM (1975) Morphological changes in the articular cartilage after meniscectomy. An experimental study in the monkey. J Bone Joint Surg [Br] 57:525–528Google Scholar
  27. 27.
    McGinty JB, Geuss LF, Marvin RA (1977) Partial or total meniscectomy. J Bone Joint Surg [Am] 59:763–766Google Scholar
  28. 28.
    Milachowski KA, Weismeier K, Wirth CJ (1989) Homologous meniscus transplantation: experimental and clinical results. Int Orthop 13:1–11PubMedGoogle Scholar
  29. 29.
    Newman AP, Anderson DR, Daniels AU, Dales MC (1989) Mechanics of the healed meniscus in a canine model. Am J Sports Med 17:164–175PubMedGoogle Scholar
  30. 30.
    Proctor CS, Schmidt MB, Whipple MA, Mow VC (1989) Material properties of the normal medial bovine meniscus. J Orthop Res 7:771–782PubMedGoogle Scholar
  31. 31.
    Radin EL, Paul IL (1970) Does cartilage compliance reduce skeletal impact loads? The relative force attenuating properties of articular cartilage, synovial fluid, periarticular soft tissues and bone. Arthritis Rheum 13:139–144PubMedGoogle Scholar
  32. 32.
    Radin EL, Martin BR, Burr DB, Caterson B, Boyd RD, Goodwin C (1984) Effects of mechanical loading on the tissues of the rabbit knee. J Orthop Res 2:221–234PubMedGoogle Scholar
  33. 33.
    Sauren AAHJ, Huson A, Schouten RY (1984) An axisysmetric finite element analysis of the mechanical function of the meniscus. Int J Sports Med [Suppl] 5:93–95Google Scholar
  34. 34.
    Schreppers GJMA, Sauren AAHJ, Huson A (1990) A numerical model of the load transmission in the tibio-femoral contact area. Proc Inst Mech Eng [H] 204:53–59Google Scholar
  35. 35.
    Seedhom BB (1979) Transmission of the load in the knee joint with special reference to the role of the menisci. I. Anatomy, analysis, and apparatus. Med Eng 8:207–219Google Scholar
  36. 36.
    Seedhom BB (1979) Transmission of the load in the knee joint with special reference to the role of the menisci. II. Experimental results, discussion, and conclusions. Med Eng 8:220–228Google Scholar
  37. 37.
    Seedhom BB (1976) Load-bearing function of the menisci. Physiotherapy 62:223–226PubMedGoogle Scholar
  38. 38.
    Seedhom BB, Dowson D, Wright V (1974) Functions of the menisci: a preliminary study. J Bone Joint Surg [Br] 56:381–382Google Scholar
  39. 39.
    Seedhom BB, Dowson D, Wright V (1974) The load-bearing function of the menisci: a preliminary study. In: Ingwersen OS, Van Linge B, Van Rens TJG, Rosingh GE, Veraart BEEMJ, LeVau D (eds) The knee joint. Excerpta Medica, Amsterdam, pp 37–42Google Scholar
  40. 40.
    Shrive N (1974) The weight-bearing role of the menisci of the knee. J Bone Joint Surg [Br] 56:381Google Scholar
  41. 41.
    Shrive N, O'Connor JJ, Goodfellow JW (1978) Load-bearing in the knee joint. Clin Orthop 131:279–287PubMedGoogle Scholar
  42. 42.
    Singerman RJ, Pederson DR, Brown TD (1987) Quantitation of pressure-sensitive film using digital image scanning. Exp Mech 27:99–105Google Scholar
  43. 43.
    Slocum B, Devine T (1983) Canine tibial thrust: a primary force in the canine stifle. J Am Vet Med Assoc 183:456–459PubMedGoogle Scholar
  44. 44.
    Stone KR, Rodkey WG, Webber RJ, McKinney L, Steadman JR (1990) Future directions: collagen-based protheses for meniscal regeneration. Clin Orthop 254:129–135Google Scholar
  45. 45.
    Tapper EM, Hoover NW (1969) Late results after meniscectomy. J Bone Joint Surg [Am] 51:517–526Google Scholar
  46. 46.
    Toyonaga T, Uezaki N, Chikama H (1983) Substitute meniscus of teflon-net for the knee joint of dogs. Clin Orthop 179:291–297PubMedGoogle Scholar
  47. 47.
    Walker PS, Erkman MJ (1975) The role of the menisci in force-transmission across the knee. Clin Orthop 109: 184–192PubMedGoogle Scholar
  48. 48.
    Webber RJ, Lyndal J, Vanderschilden JL, Hough AJ (1989) An organ culture model for assaying wound repair of the fibrocartilaginous knee joint meniscus. Am J Sports Med 17:393–400PubMedGoogle Scholar
  49. 49.
    Winer BJ (1971) Statistical principles in experimental design, 2nd edn. McGraw-Hill, New York, pp 201–203Google Scholar
  50. 50.
    Woo SL-Y, Weiss JA, Gomez MA, Hawkins DA (1990) Measurement of changes in knec ligament tension with knee motion and skeletal maturation. J Biomech Eng 112:46–51PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • D. R. Anderson
    • 1
  • A. P. Newman
    • 2
  • A. U. Daniels
    • 3
  1. 1.Department of OrthopaedicsUniversity of Tennessee, Chattanooga and Erlanger Medical CenterChattanoogaUSA
  2. 2.Division of Orthopedic SurgeryUniversity of Utah School of Medicine and Department of Veterans Affairs Medical CenterSalt Lake CityUSA
  3. 3.Osteonics CorporationAllendaleUSA

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