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Biomechanical impact of meniscal ramp lesions on knee joint contact characteristics in ACL deficient knees: a cadaveric analysis

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the changes in contact characteristics of the tibiofemoral joint resulting from a meniscal ramp lesion in the medial meniscus.

Methods

Twelve cadaveric knees (six matched pairs) were subjected to a 600 N axial load using a custom testing jig, which allowed for knee positioning at 0°, 45°, and 90° of flexion without other constraints. The knees were randomly assigned to either a ramp lesion group (n = 6) or a posterior root lesion group (n = 6). Four testing conditions were examined: (1) intact, (2) isolated ramp lesion, (3) isolated posterior root tear of the medial meniscus, and (4) combined ramp lesion and posterior root tear of the medial meniscus. Contact characteristics were evaluated using a flexible pressure sensor, the I-Scan System.

Results

Peak contact pressure in isolated ramp lesions (4.15 ± 0.98 MPa, P = 0.206) showed non-significant increases compared to the intact condition (3.86 ± 1.32 MPa). Peak contact pressure in isolated posterior root tears (4.58 ± 1.70 MPa, P = 0.040) and, combined ramp and posterior root lesions (4.67 ± 1.47 MPa, P = 0.003) were significantly higher than that in the intact condition. The knee flexion position significantly affected the medial tibiofemoral joint’s contact area, contact pressure, and peak contact pressure (P < 0.001 for all).

Conclusion

Isolated ramp lesions did not significantly impact force transmission, contact area, or contact pressure. In contrast, isolated root lesions and combined ramp and posterior root tears of the medial meniscus significantly intensified the changes in contact characteristics in the medial tibiofemoral joint compared to the intact condition.

Level of evidence

Level III.

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Acknowledgements

This study was granted by Faculty of Medicine, Khon Kaen University, Thailand (Grant Number IN64329). The authors are deeply indebted to Kriengkrai Nabudda for his expert advice and suggestions regarding the machinery used in the laboratory.

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Authors and Affiliations

  1. Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Road, Muang District, Khon Kaen, 40002, Thailand

    Artit Boonrod, Khananut Jaruwanneechai & Sermsak Sumanont

  2. Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

    Nadhaporn Saengpetch

  3. Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand

    Parichat Prachaney

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  1. Artit Boonrod
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Contributions

AB, KJ, NS, SS, PP conceived the study concept and designed the study. AB and KJ were involved in the acquisition of data and helped to draft the manuscript. AB, KJ and NS participated in the data analysis, performed the statistical analysis, and drafted the manuscript. All authors participated in editing the manuscript. All authors read and approved the final manuscript.

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Correspondence to Artit Boonrod.

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This was approved by the Research Ethics Board at Khon Kaen University (HE641419).

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Boonrod, A., Jaruwanneechai, K., Saengpetch, N. et al. Biomechanical impact of meniscal ramp lesions on knee joint contact characteristics in ACL deficient knees: a cadaveric analysis. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03995-7

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