A longitudinal tear in the medial meniscal body decreased the in situ meniscus force under an axial load
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KNEE
A longitudinal tear in the medial meniscal body decreased the in situ meniscus force under an axial load Yuta Tachibana1 · Tatsuo Mae1 · Konsei Shino2 · Tomoki Ohori1 · Hiromichi Fujie3 · Hideki Yoshikawa1 · Ken Nakata1 Received: 20 February 2019 / Accepted: 26 September 2019 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019
Abstract Purpose To clarify the effect of longitudinal tears of the medial meniscus on the in situ meniscus force and the tibiofemoral relationship under axial load. Methods Twenty-one intact porcine knees were mounted on a 6-degrees of freedom robotic system, and the force and threedimensional path of the knee joints were recorded during three cycles under a 250-N axial load at 30°, 60°, 90° and 120° of knee flexion. They were divided into three groups of seven knees with longitudinal tears in the middle to the posterior segment of the medial meniscus based on the tear site: rim, outer one-third and inner one-third of the meniscal body. After creating tears, the same tests were performed. Finally, all paths were reproduced after total medial meniscectomy, and the in situ force of the medial meniscus was calculated based on the principle of superposition. Results With a longitudinal tear, the in situ force of the medial meniscus was significantly decreased at 60°, 90° and 120° of knee flexion, regardless of the tear site. The decrement was greater with a tear in the meniscal body than a tear in the rim. A longitudinal tear in the meniscal body caused a significantly greater tibial varus rotation than a tear in the rim at all flexion angles. Conclusion Longitudinal tears significantly decreased the in situ force of the medial meniscus. Tears in the meniscal body caused a larger decrease of the in situ meniscus force and greater varus tibial rotation than tears in the rim. Keywords Axial load · In situ force · Longitudinal tear · Medial meniscus · Porcine knee · Six-degrees of freedom robotic system · Tibiofemoral relationship Abbreviations 3-D Three-dimensional UFS Universal force/moment sensor
* Yuta Tachibana [email protected] 1
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2‑2, Yamada‑oka, Suita 565‑0871, Osaka, Japan
2
Sports Orthopaedic Surgery, Yukioka Hospital, 2‑2‑3, Ukita, Kita‑ku, Osaka 530‑0021, Osaka, Japan
3
Biomechanics Laboratory, Faculty of System Design, Tokyo Metropolitan University, 1‑1, Minami‑Osawa, Hachioji 192‑0397, Tokyo, Japan
Introduction The meniscus plays an important role in the knee joint such as load distribution and transmission, stabilisation, lubrication and shock absorption. Load distribution and transmission are important functions to protect the articular cartilage by increasing the contact area while decreasing contact pressure [1, 3, 18, 21]. Isolated meniscal tears are common among young athletes with high activity levels [26, 29]. Particularly, longitudinal tears (e.g., bucket-handle tears) of the medial meniscus have been frequently associated with ar
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