The effect of medial meniscal horn injury on knee stability (original) (raw)
The insertion of the anterior horn of the medial meniscus: an anatomic study
Muscles, ligaments and tendons journal, 2013
The purpose of this study was to identify the various patterns of insertion of the anterior horn of the medial meniscus in Ghanaian subjects. The study involved 35 cadaveric knees (26 males and 9 females). Berlet and Fowler classification was used to classify the insertion of the anterior horn of the medila meniscus. The distribution of the insertion pattern was as follows; 42.9% (15) had type I insertion, 45.7% (16) had type II, type III and IV insertions were each found in 5.7% (2) of the dissected knees. Type II insertion had the highest incidence which was a deviation from what has been reported in literature. The incidence of the anterior intermeniscal ligament (AIML) was 34.3%, which was much lower that most studies have reported. The findings of the study may suggest that the pattern of insertion of the anterior horn of the medial meniscus may be different in the Ghanaian population; further research is needed in this area.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2014
Purpose: To evaluate the effect of the meniscofemoral ligament (MFL) in maintaining lateral-compartment contact pressures after injury to the posterior root of the lateral meniscus, and to measure the ability to restore intra-articular loads to normal by repairing the posterior root to the tibia after transection of the posterior root and the MFL. Methods: Ten human cadaveric knee joints were axially loaded to 100 N. A digital pressure sensor measured the contact pressure in the lateral compartment. Five different conditions were tested: intact, after release of the posterior root of the lateral meniscus, after transection of the MFL along with release of the posterior root, refixation of the posterior root of the lateral meniscus to the tibia using an anatomic transosseous tunnel, and refixation of the root of the lateral meniscus using a tibial anterior cruciate ligament (ACL) tunnel. Results: After transection of the posterior lateral meniscus root, the contact pressure did not increase significantly. The additional transection of the MFL led to a significant increase in the contact pressure. Anatomic fixation of the meniscus posterior horn reduced the femorotibial pressure to nearly pre-sectioning values. The reattachment of the meniscus posterior horn through a tibial ACL tunnel was equivalent to an anatomic fixation. Conclusions: In the case of a root tear of the lateral meniscus, the MFL maintains meniscus function and stabilizes the pressure in the lateral compartment. A complete detachment of the posterior meniscus horn (MFL and root tear) leads to an increase in the intra-articular pressure. A root repair normalizes the pressure down to normal values. The tibial ACL tunnel is suitable to perform the repair and to lead out the suture. Clinical Relevance: In the case of a complete detachment of the meniscus posterior horn, fixation of the posterior root is necessary to restore the meniscus function and to guarantee an equal pressure distribution in the lateral compartment. It can be combined with an ACL reconstruction. T he knee joint menisci increase femorotibial congruency, and they contribute significantly to load transmission and joint stability. During load transmission, the forces acting on the meniscus are transformed into circumferential hoop stress. 1 This circular hoop stress is transmitted to the tibial plateau by the anterior and posterior roots of the menisci. 1 Therefore From the Klinik für Orthopädie und Unfallchirurgie,
Anterior Horn Tears of the Lateral Meniscus in Soccer Players
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2006
The purpose of this retrospective study was to define the clinical and arthroscopic characteristics of anterior horn tears of the lateral meniscus. Type of Study: Case series. Methods: Fourteen patients with mean age of 20.2 years were enrolled in this institutional review boardapproved study. All patients were soccer players with tears of the anterior horn of the lateral meniscus. All patients underwent physical examinations, magnetic resonance imaging (MRI), and arthroscopic treatment. Results: Common symptoms were a catching sensation in 10 patients (71.4%), pain at squatting in 9 patients (64.3%), and sense of giving way and effusion, each in 7 patients (50%). Five patients (35.7%) had lateral joint-line tenderness. McMurray's test was positive in 6 (42.9%) and tears were diagnosed by MRI in 13 (92.8%) patients. Arthroscopic examination showed multiple longitudinal tears in the avascular white zone of the meniscus in 7 patients (50%). Conclusions: These data show that the McMurray test and joint-line tenderness had a low diagnostic value in diagnosing anterior horn tears of the lateral meniscus. MRI, however, had a high diagnostic value. Common arthroscopic findings included multiple longitudinal tears within the white zone of the anterior horn. Level of Evidence: Level IV.
Change in Meniscal Strain with Anterior Cruciate Ligament Injury and After Reconstruction
The American Journal of Sports Medicine, 2000
Meniscal injury has been well documented in association with injury to the anterior cruciate ligament. The purpose of this study was to evaluate the effect of anterior cruciate ligament transection and reconstruction on meniscal strain. Four differential variable reluctance transducer strain gauges were placed in the medial and lateral menisci of nine cadaveric knees. Each specimen was mounted to a six-degree-of-freedom knee testing device. Testing was conducted with the knee fully extended and at 45°and 90°of flexion, both with and without applied axial load. At each angle of flexion, an anterior and posterior tibial load was applied. Next, the anterior cruciate ligament was transected and the testing sequence was repeated. Finally, the ligament was reconstructed using a central one-third patellar tendon graft and the testing sequence was repeated. The results demonstrated statistically significant increases in meniscal strain in ligament-transected knees compared with intact specimens. A reduction in meniscal strain to a level similar to that detected in the ligamentintact knees was observed after anterior cruciate ligament reconstruction. These results have important clinical implications regarding the potentially deleterious effect of the anterior cruciate ligament-deficient knee on meniscal strain and the potential benefit of anterior cruciate ligament reconstruction.
Orthopaedic journal of sports medicine, 2017
The biomechanical effects of lateral meniscal posterior root tears with and without meniscofemoral ligament (MFL) tears in anterior cruciate ligament (ACL)-deficient knees have not been studied in detail. To determine the biomechanical effects of the lateral meniscus (LM) posterior root tear in ACL-intact and ACL-deficient knees. In addition, the biomechanical effects of disrupting the MFLs in ACL-deficient knees with meniscal root tears were evaluated. Controlled laboratory study. Ten paired cadaveric knees were mounted in a 6-degrees-of-freedom robot for testing and divided into 2 groups. The sectioning order for group 1 was (1) ACL, (2) LM posterior root, and (3) MFLs, and the order for group 2 was (1) LM posterior root, (2) ACL, and (3) MFLs. For each cutting state, displacements and rotations of the tibia were measured and compared with the intact state after a simulated pivot-shift test (5-N·m internal rotation torque combined with a 10-N·m valgus torque) at 0°, 20°, 30°, 60°,...
Knee Surgery, Sports Traumatology, Arthroscopy, 2020
Purpose The purpose of this study was to determine the effects of a lateral meniscus posterior root tear, partial meniscectomy, and total meniscectomy on knee biomechanics in the setting of anterior cruciate ligament (ACL) reconstruction. Methods Thirteen fresh-frozen cadaver knees were tested with a robotic testing system under an 89.0-N anterior tibial load at full extension (FE), 15°, 30°, 60° and 90° of knee flexion and a simulated pivot-shift loading (7.0 Nm valgus and 5.0 Nm internal tibial rotation) at FE, 15° and 30° of knee flexion. Anterior tibial translation (ATT) and the in-situ force of ACL graft under the different loadings were measured in four knee states: (1) ACL reconstruction with intact lateral meniscus (Intact meniscus), (2) ACL reconstruction with lateral meniscal posterior root tear (Root tear), (3) ACL reconstruction with lateral posterior partial meniscectomy (Partial meniscectomy) and (4) ACL reconstruction with total lateral meniscectomy (Total meniscectomy). Results Under anterior tibial loading, compared with an intact meniscus, root tear significantly increased ATT at 15° and 30° of knee flexion (p < 0.05) and partial meniscectomy had almost same increased ATT as with root tear at any knee flexion between FE and 90°. Under simulated pivot-shift loading, total meniscectomy increased ATT compared with intact meniscus, root tear, partial meniscectomy at FE (p < 0.05). Conclusion Under anterior tibial and simulated pivot-shift loading, partial meniscectomy has no significant effect on the stability of ACL-reconstructed knee with lateral meniscal posterior root tear, while total meniscectomy increased laxity at less than 30° of knee flexion. Clinically, in cases of irreparable meniscal root tears or persistent pain a partial meniscectomy can be considered in the setting of ACL reconstruction.
Association of Meniscus Injuries in Patients With Anterior Cruciate Ligament Injuries
Cureus, 2022
Introduction: In today's orthopaedic practice, meniscus and anterior cruciate ligament (ACL) injuries are prevalent. It is more common in sports injuries and automobile accidents. In patients with ACL tears, meniscus problems are also common. Several studies have linked meniscus injuries to the development of osteoarthritis in early stages. Early onset of osteoarthritis has been observed in ACL-repaired patients with meniscus tears. As a result, meniscus tears should be detected and corrected as soon as possible to avoid degenerative changes in the knee joint. The goal of the study was to see if there was a link between meniscus injuries and ACL injuries in our rural community. Methods: This retrospective study was conducted on 48 patients at the R.L. Jalappa Hospital & Research Centre from January 2012 to December 2019. Patients between the ages of 18-65 diagnosed with ACL tear with/without meniscus damage in their knees were included in the study. Patients with posterior cruciate ligament (PCL) tear, medial collateral ligament (MCL) or lateral collateral ligament (LCL) injury, previously operated index knees, and patients with more than grade 3 knee osteoarthritis (Kellgren and Lawrence classification) were excluded. Clinical assessment of patients with knee injuries, MRI and diagnostic arthroscopy of the knee joint details were collected. After obtaining the data, we estimated the incidence of meniscus injuries associated with chronic ACL injuries. We also calculated the percentage of side/laterality injury (medial meniscus or lateral meniscus) and part of meniscus injury (anterior horn, body, and posterior horn) in chronic ACL-deficient knees. Patient characteristics such as age and gender were correlated with functional knee assessment using a modified Lysholm score. P-value and chi-square tests were used to assess the data. P-value of less than 0.5 was considered significant. Results: Average age of the participants was 32.31 years. There were 42 men and six women in the group. Isolated medial meniscus, lateral meniscus, and combined medial and lateral meniscus had average ages of 31.83, 31.16, and 40.28 years, respectively. ACL injuries on the right side were seen in 23 patients the left side was seen in 25 patients. In comparison to the right side, the isolated medial meniscus injury on the left side was more severe. In case of a combination of medial and lateral meniscus tears, the right side suffered more damage than the left. Eleven patients had an isolated ACL tear without a meniscus injury, while the other 37 had a meniscus injury and an ACL tear. Excellent scores were observed in 11 cases, satisfactory scores in 26, and unsatisfactory in 11 cases. Age group was categorized into three groups, less than 30, 30-45, and more than 45 years. Excellent, satisfactory, and unsatisfactory scores were observed in seven, eleven, and seven patients on the left side and excellent, satisfactory, and unsatisfactory scores in four, fifteen, and four patients on the right side, respectively. P-value was not statistically significant when comparing outcomes by age, gender, or side. Conclusion: Meniscus injuries occurred 77% of the time when there was a persistent ACL injury. In comparison to a lateral meniscus injury, the incidence of medial meniscus injury associated with chronic ACL tear was higher. In comparison to the anterior horn and body of the medial meniscus, the majority of medial meniscus tears were found in the posterior horn.
The effects of partial meniscectomy and meniscal repair on the knee proprioception and function
Journal of Orthopaedic Surgery, 2020
Purpose: Aim of our study was to compare the effects of partial meniscectomy and meniscus repair on knee proprioception and function. Methods: The study included 46 patients with clinical and radiological diagnosis of meniscal tear and accompanying anterior cruciate ligament (ACL) rupture. The patients were evaluated under two groups: group 1: partial meniscectomy and ACL reconstruction, and group 2: meniscal repair and ACL reconstruction. Proprioceptive and functional evaluation of all patients was performed prior to surgery and on postoperative 12th month. Results: Group 1 consists of 18 male and 1 female patients with an average age of 28.78 ± 3.50. Group 2 consists of 23 male and 4 female patients with an average age of 27.14 ± 3.65. Preoperative evaluation revealed significant differences in knee joint position sense values on wide range of knee motion (15°, 30°, 45°, 60°, and 75°) in both groups. The statistically significant difference was observed in only the range of knee m...