The Effect of Medial Meniscectomy and Meniscal Allograft Transplantation on Knee and Anterior Cruciate Ligament Biomechanics

Purpose Our purpose was to evaluate the effect of meniscectomy and meniscal allograft transplant on anterior cruciate ligament (ACL) and knee biomechanics. Methods A differential variable reluctance transducer was placed in the ACL of 10 human cadaveric knees to record strain. Tibial displacement fr...

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Veröffentlicht in:Arthroscopy 2010-02, Vol.26 (2), p.192-201
Hauptverfasser: Spang, Jeffrey T., M.D, Dang, Alan B.C., M.D, Mazzocca, Augustus, M.D, Rincon, Lina, M.E, Obopilwe, Elifho, M.S, Beynnon, Bruce, Ph.D, Arciero, Robert A., M.D
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container_end_page 201
container_issue 2
container_start_page 192
container_title Arthroscopy
container_volume 26
creator Spang, Jeffrey T., M.D
Dang, Alan B.C., M.D
Mazzocca, Augustus, M.D
Rincon, Lina, M.E
Obopilwe, Elifho, M.S
Beynnon, Bruce, Ph.D
Arciero, Robert A., M.D
description Purpose Our purpose was to evaluate the effect of meniscectomy and meniscal allograft transplant on anterior cruciate ligament (ACL) and knee biomechanics. Methods A differential variable reluctance transducer was placed in the ACL of 10 human cadaveric knees to record strain. Tibial displacement from a neutral reference was recorded relative to the position of the femur. Testing was performed at 30°, 60°, and 90° of knee flexion. Six cycles of anterior-posterior loads were applied to the limit of 150 N. After a testing cycle, a medial meniscectomy was performed and the testing cycle was repeated. A meniscal allograft transplant was performed, and a final testing cycle was conducted. ACL strain and tibial displacement in the meniscectomy and meniscal allograft states were compared with the intact-knee state. Results Tibial displacement after meniscectomy significantly increased at all angles. The meniscal allograft transplant restored tibial displacement to normal values at 30° and 90°. ACL strain increased significantly after meniscectomy at 60° and 90° of flexion, and meniscal allograft transplant returned the strain values to normal at 60° and 90°. Conclusions In most cases medial meniscectomy produced a significant increase in tibial displacement relative to the femur, and meniscal allograft transplantation restored displacement values to normal. Meniscectomy increased ACL strain and meniscal allograft transplant restored strain values to normal in 2 of 3 tested flexion angles. Clinical Relevance The absence of the medial meniscus exposes the ACL to increased strain, whereas meniscal allograft lowered the strain on the native ACL. This could have implications for those patients undergoing ACL reconstruction who have concomitant removal of the medial meniscus.
doi_str_mv 10.1016/j.arthro.2009.11.008
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Methods A differential variable reluctance transducer was placed in the ACL of 10 human cadaveric knees to record strain. Tibial displacement from a neutral reference was recorded relative to the position of the femur. Testing was performed at 30°, 60°, and 90° of knee flexion. Six cycles of anterior-posterior loads were applied to the limit of 150 N. After a testing cycle, a medial meniscectomy was performed and the testing cycle was repeated. A meniscal allograft transplant was performed, and a final testing cycle was conducted. ACL strain and tibial displacement in the meniscectomy and meniscal allograft states were compared with the intact-knee state. Results Tibial displacement after meniscectomy significantly increased at all angles. The meniscal allograft transplant restored tibial displacement to normal values at 30° and 90°. ACL strain increased significantly after meniscectomy at 60° and 90° of flexion, and meniscal allograft transplant returned the strain values to normal at 60° and 90°. Conclusions In most cases medial meniscectomy produced a significant increase in tibial displacement relative to the femur, and meniscal allograft transplantation restored displacement values to normal. Meniscectomy increased ACL strain and meniscal allograft transplant restored strain values to normal in 2 of 3 tested flexion angles. Clinical Relevance The absence of the medial meniscus exposes the ACL to increased strain, whereas meniscal allograft lowered the strain on the native ACL. This could have implications for those patients undergoing ACL reconstruction who have concomitant removal of the medial meniscus.</description><identifier>ISSN: 0749-8063</identifier><identifier>EISSN: 1526-3231</identifier><identifier>DOI: 10.1016/j.arthro.2009.11.008</identifier><identifier>PMID: 20141982</identifier><identifier>CODEN: ARTHE3</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Anterior Cruciate Ligament - diagnostic imaging ; Anterior Cruciate Ligament - physiology ; Arthroscopy ; Biological and medical sciences ; Biomechanical Phenomena ; Biomechanics. Biorheology ; Body Weight ; Cadaver ; Endoscopy ; Femur - anatomy &amp; histology ; Femur - diagnostic imaging ; Femur - physiology ; Freezing ; Fundamental and applied biological sciences. Psychology ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Knee Joint - anatomy &amp; histology ; Knee Joint - diagnostic imaging ; Knee Joint - physiology ; Knee Joint - surgery ; Medical sciences ; Menisci, Tibial - diagnostic imaging ; Menisci, Tibial - physiology ; Menisci, Tibial - surgery ; Menisci, Tibial - transplantation ; Orthopedic surgery ; Orthopedics ; Radiography ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Tissue Donors ; Tissues, organs and organisms biophysics ; Transplantation, Homologous - methods</subject><ispartof>Arthroscopy, 2010-02, Vol.26 (2), p.192-201</ispartof><rights>Arthroscopy Association of North America</rights><rights>2010 Arthroscopy Association of North America</rights><rights>2015 INIST-CNRS</rights><rights>(c) 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-19b9795c9d888e423c40f83889da4a267f7e8a7153d5fb5e38a7c9d99ad3e39f3</citedby><cites>FETCH-LOGICAL-c446t-19b9795c9d888e423c40f83889da4a267f7e8a7153d5fb5e38a7c9d99ad3e39f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0749806309009529$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=22384162$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20141982$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spang, Jeffrey T., M.D</creatorcontrib><creatorcontrib>Dang, Alan B.C., M.D</creatorcontrib><creatorcontrib>Mazzocca, Augustus, M.D</creatorcontrib><creatorcontrib>Rincon, Lina, M.E</creatorcontrib><creatorcontrib>Obopilwe, Elifho, M.S</creatorcontrib><creatorcontrib>Beynnon, Bruce, Ph.D</creatorcontrib><creatorcontrib>Arciero, Robert A., M.D</creatorcontrib><title>The Effect of Medial Meniscectomy and Meniscal Allograft Transplantation on Knee and Anterior Cruciate Ligament Biomechanics</title><title>Arthroscopy</title><addtitle>Arthroscopy</addtitle><description>Purpose Our purpose was to evaluate the effect of meniscectomy and meniscal allograft transplant on anterior cruciate ligament (ACL) and knee biomechanics. Methods A differential variable reluctance transducer was placed in the ACL of 10 human cadaveric knees to record strain. Tibial displacement from a neutral reference was recorded relative to the position of the femur. Testing was performed at 30°, 60°, and 90° of knee flexion. Six cycles of anterior-posterior loads were applied to the limit of 150 N. After a testing cycle, a medial meniscectomy was performed and the testing cycle was repeated. A meniscal allograft transplant was performed, and a final testing cycle was conducted. ACL strain and tibial displacement in the meniscectomy and meniscal allograft states were compared with the intact-knee state. Results Tibial displacement after meniscectomy significantly increased at all angles. The meniscal allograft transplant restored tibial displacement to normal values at 30° and 90°. ACL strain increased significantly after meniscectomy at 60° and 90° of flexion, and meniscal allograft transplant returned the strain values to normal at 60° and 90°. Conclusions In most cases medial meniscectomy produced a significant increase in tibial displacement relative to the femur, and meniscal allograft transplantation restored displacement values to normal. Meniscectomy increased ACL strain and meniscal allograft transplant restored strain values to normal in 2 of 3 tested flexion angles. Clinical Relevance The absence of the medial meniscus exposes the ACL to increased strain, whereas meniscal allograft lowered the strain on the native ACL. 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Psychology</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Knee Joint - anatomy &amp; histology</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Knee Joint - physiology</subject><subject>Knee Joint - surgery</subject><subject>Medical sciences</subject><subject>Menisci, Tibial - diagnostic imaging</subject><subject>Menisci, Tibial - physiology</subject><subject>Menisci, Tibial - surgery</subject><subject>Menisci, Tibial - transplantation</subject><subject>Orthopedic surgery</subject><subject>Orthopedics</subject><subject>Radiography</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Biorheology</topic><topic>Body Weight</topic><topic>Cadaver</topic><topic>Endoscopy</topic><topic>Femur - anatomy &amp; histology</topic><topic>Femur - diagnostic imaging</topic><topic>Femur - physiology</topic><topic>Freezing</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Knee Joint - anatomy &amp; histology</topic><topic>Knee Joint - diagnostic imaging</topic><topic>Knee Joint - physiology</topic><topic>Knee Joint - surgery</topic><topic>Medical sciences</topic><topic>Menisci, Tibial - diagnostic imaging</topic><topic>Menisci, Tibial - physiology</topic><topic>Menisci, Tibial - surgery</topic><topic>Menisci, Tibial - transplantation</topic><topic>Orthopedic surgery</topic><topic>Orthopedics</topic><topic>Radiography</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Tissue Donors</topic><topic>Tissues, organs and organisms biophysics</topic><topic>Transplantation, Homologous - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spang, Jeffrey T., M.D</creatorcontrib><creatorcontrib>Dang, Alan B.C., M.D</creatorcontrib><creatorcontrib>Mazzocca, Augustus, M.D</creatorcontrib><creatorcontrib>Rincon, Lina, M.E</creatorcontrib><creatorcontrib>Obopilwe, Elifho, M.S</creatorcontrib><creatorcontrib>Beynnon, Bruce, Ph.D</creatorcontrib><creatorcontrib>Arciero, Robert A., M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Arthroscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spang, Jeffrey T., M.D</au><au>Dang, Alan B.C., M.D</au><au>Mazzocca, Augustus, M.D</au><au>Rincon, Lina, M.E</au><au>Obopilwe, Elifho, M.S</au><au>Beynnon, Bruce, Ph.D</au><au>Arciero, Robert A., M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Medial Meniscectomy and Meniscal Allograft Transplantation on Knee and Anterior Cruciate Ligament Biomechanics</atitle><jtitle>Arthroscopy</jtitle><addtitle>Arthroscopy</addtitle><date>2010-02-01</date><risdate>2010</risdate><volume>26</volume><issue>2</issue><spage>192</spage><epage>201</epage><pages>192-201</pages><issn>0749-8063</issn><eissn>1526-3231</eissn><coden>ARTHE3</coden><abstract>Purpose Our purpose was to evaluate the effect of meniscectomy and meniscal allograft transplant on anterior cruciate ligament (ACL) and knee biomechanics. Methods A differential variable reluctance transducer was placed in the ACL of 10 human cadaveric knees to record strain. Tibial displacement from a neutral reference was recorded relative to the position of the femur. Testing was performed at 30°, 60°, and 90° of knee flexion. Six cycles of anterior-posterior loads were applied to the limit of 150 N. After a testing cycle, a medial meniscectomy was performed and the testing cycle was repeated. A meniscal allograft transplant was performed, and a final testing cycle was conducted. ACL strain and tibial displacement in the meniscectomy and meniscal allograft states were compared with the intact-knee state. Results Tibial displacement after meniscectomy significantly increased at all angles. The meniscal allograft transplant restored tibial displacement to normal values at 30° and 90°. ACL strain increased significantly after meniscectomy at 60° and 90° of flexion, and meniscal allograft transplant returned the strain values to normal at 60° and 90°. Conclusions In most cases medial meniscectomy produced a significant increase in tibial displacement relative to the femur, and meniscal allograft transplantation restored displacement values to normal. Meniscectomy increased ACL strain and meniscal allograft transplant restored strain values to normal in 2 of 3 tested flexion angles. Clinical Relevance The absence of the medial meniscus exposes the ACL to increased strain, whereas meniscal allograft lowered the strain on the native ACL. This could have implications for those patients undergoing ACL reconstruction who have concomitant removal of the medial meniscus.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20141982</pmid><doi>10.1016/j.arthro.2009.11.008</doi><tpages>10</tpages></addata></record>
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subjects Anterior Cruciate Ligament - diagnostic imaging
Anterior Cruciate Ligament - physiology
Arthroscopy
Biological and medical sciences
Biomechanical Phenomena
Biomechanics. Biorheology
Body Weight
Cadaver
Endoscopy
Femur - anatomy & histology
Femur - diagnostic imaging
Femur - physiology
Freezing
Fundamental and applied biological sciences. Psychology
Humans
Investigative techniques, diagnostic techniques (general aspects)
Knee Joint - anatomy & histology
Knee Joint - diagnostic imaging
Knee Joint - physiology
Knee Joint - surgery
Medical sciences
Menisci, Tibial - diagnostic imaging
Menisci, Tibial - physiology
Menisci, Tibial - surgery
Menisci, Tibial - transplantation
Orthopedic surgery
Orthopedics
Radiography
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tissue Donors
Tissues, organs and organisms biophysics
Transplantation, Homologous - methods
title The Effect of Medial Meniscectomy and Meniscal Allograft Transplantation on Knee and Anterior Cruciate Ligament Biomechanics
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