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

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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Authors and Affiliations

  1. Department of Orthopaedics, University of Tennessee, Chattanooga and Erlanger Medical Center, Chattanooga, Tennessee, USA

    D. R. Anderson

  2. Division of Orthopedic Surgery, University of Utah School of Medicine and Department of Veterans Affairs Medical Center, 50 N. Mcdical Dr., 84132, Salt Lake City, Utah, USA

    A. P. Newman MD

  3. Osteonics Corporation, Allendale, New Jersey, USA

    A. U. Daniels

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  1. D. R. Anderson
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  2. A. P. Newman MD
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  3. A. U. Daniels
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Anderson, D.R., Newman, A.P. & Daniels, A.U. In vitro load transmission in the canine knee: The effect of medial meniscectomy and varus rotation. Knee Surg, Sports traumatol, Arthroscopy 1, 44–50 (1993). https://doi.org/10.1007/BF01552158

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