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

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.

journal_name

Int Orthop

authors

Lorbach O,Kieb M,Herbort M,Weyers I,Raschke M,Engelhardt M

doi

10.1007/s00264-014-2581-x

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

681-7

issue

4

eissn

0341-2695

issn

1432-5195

journal_volume

39

pub_type

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