Mechanical properties and morphological analysis of the transitional zone between meniscal body and ligamentous meniscal attachments

In recent years, an increasing number of studies reporting on meniscal root tears have been published. While the meniscus and its ligamentous meniscal attachments have been studied before, little is known about the transitional zone between these two structures. Therefore, the aim of this study was to mechanically and morphologically characterize the transitional zone between meniscus and its meniscal attachments. Dumbbell-shaped specimens were obtained from the transitional zone between meniscus and its meniscal attachments of 6 knee joints. Samples were divided into tibial and central layers of the anterior lateral (AL), anterior medial (AM), posterior lateral (PL) and posterior medial (PM) transitional region. Testing was performed to obtain the dissipated energy during hysteresis as well as the linear modulus (E-lin), the maximum strain (epsilon(max)), the maximum engineering stress (sigma(max,eng)) and location of rupture during tensile test to failure. Two additional knee joints were used to investigate morphological differences between meniscus, transitional zone and meniscal attachments in 8 mu m transverse slices. The central layer of the AL, AM and PL dissipated up to 48% less energy than the tibial layer. E-lin was highest in the tibial layer of the PM with 107.4 +/- 61.1 MPa and lowest in the central layer of the PL with 56.0 +/- 20.5 MPa. The maximum strain was higher in the central layer than in the tibial layer at the AL, AM, and PL locations. The average sigma(max,eng) was 12.7 +/- 9.9 MPa over all location and layers. 78% of the samples ruptured during tensile test to failure in the transitional zone. The morphological evaluation showed a smooth transitional zone with a transitional curve which was either linear or bell-shaped. The strength found in the transitional zone was lower than in the meniscus and the meniscal attachments, which corresponds well to clinical findings. (C) 2015 Elsevier Ltd. All rights reserved.