Dynamic Contact Mechanics of Radial Tears of the Lateral Meniscus: Implications for Treatment

被引:111
作者
Bedi, Asheesh [1 ,2 ]
Kelly, Natalie [2 ]
Baad, Michael [3 ]
Fox, Alice J. S. [2 ]
Ma, Yan [2 ]
Warren, Russell F. [2 ]
Maher, Suzanne A. [2 ]
机构
[1] Univ Michigan, Ann Arbor, MI 48106 USA
[2] Hosp Special Surg, New York, NY 10021 USA
[3] Weill Cornell Med Sch, New York, NY USA
关键词
FINITE-ELEMENT-ANALYSIS; TOTAL KNEE REPLACEMENTS; MEDIAL MENISCUS; PARTIAL MENISCECTOMY; IN-VITRO; PRESSURE; REPAIR; CONSEQUENCES; BIOMECHANICS; ACCURACY;
D O I
10.1016/j.arthro.2011.08.287
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: To characterize the effect of radial tears (RTs) of the lateral meniscus and their subsequent treatment (inside-out repair, partial meniscectomy) on joint contact mechanics during simulated gait. Methods: Six human cadaveric knees were mounted on a simulator programmed to mimic human gait. A sensor was inserted below the lateral meniscus to measure peak joint contact pressure location, magnitude, and contact area. The following conditions were compared: intact meniscus, 30% RT (at the popliteal hiatus), 60% RT, 90% RT, repair, and partial meniscectomy. Data were analyzed in the midstance phase of gait (14% and 45%) when axial force was at its highest (2,100 N). Results: Intact knees had peak contact pressures of 5.9 +/- 0.9 MPa and 6.4 +/- 1.1 MPa at 14% and 45% of gait, respectively. RTs of up to and including 60% had no effect on pressure magnitude or location. RTs of 90% resulted in significantly increased peak pressure (8.4 +/- 1.1 MPa) in the postero-peripheral aspect of the tibial plateau and reduced contact area versus the intact knee, at 45% of gait. Repair resulted in a significant decrease in peak pressure (7.7 +/- 1.0 MPa) relative to 90% RT but had no effect on contact area. Partial lateral meniscectomy resulted in areas and pressures that were not significantly different from 90% tears (8.7 +/- 1.5 MPa). Conclusions: Simulated large RTs of the lateral meniscus in the region of the popliteal hiatus show unfavorable dynamic contact mechanics that are not significantly different from those resulting from a partial lateral meniscectomy. Pressure was significantly reduced with inside-out repair but was not affected by partial meniscectomy; contact area was not restored to that of the intact condition for either procedure. Clinical Relevance: Large RTs in the region of the popliteal hiatus show unfavorable dynamic contact mechanics.
引用
收藏
页码:372 / 381
页数:10
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