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

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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.

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Acknowledgments

The study was supported in part by a grant of the Society for Arthroscopy and Joint Surgery (AGA). The authors further thank Dr. Thomas Georg for the statistical support of the study.

Conflict of interest

No potential conflict of interest declared.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Saarland University, Kirrberger Str., Geb 37, 66421, Homburg (Saar), Germany

    Olaf Lorbach

  2. Department of Orthopaedic Surgery, Rostock University, Rostock, Germany

    Matthias Kieb

  3. Department of Trauma, Hand- and Reconstructive Surgery, Münster University, Münster, Germany

    Mirco Herbort & Michael Raschke

  4. Department of Anatomy, Lübeck University, Lübeck, Germany

    Imke Weyers

  5. Department of Trauma, Hand- and Orthopaedic Surgery, Osnabrück, Germany

    Martin Engelhardt

Authors
  1. Olaf Lorbach
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  2. Matthias Kieb
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  3. Mirco Herbort
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  4. Imke Weyers
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  5. Michael Raschke
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  6. Martin Engelhardt
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Correspondence to Olaf Lorbach.

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Lorbach, O., Kieb, M., Herbort, M. et al. The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee. International Orthopaedics (SICOT) 39, 681–687 (2015). https://doi.org/10.1007/s00264-014-2581-x

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  • DOI: https://doi.org/10.1007/s00264-014-2581-x

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