Tibiofemoral Contact Mechanics with Horizontal Cleavage Tear and Resection of the Medial Meniscus in the Human Knee

2016 ◽  
Vol 98 (21) ◽  
pp. 1829-1836 ◽  
Author(s):  
Jason L. Koh ◽  
Seung Jin Yi ◽  
Yupeng Ren ◽  
Todd A. Zimmerman ◽  
Li-Qun Zhang
Keyword(s):  
Contact Mechanics ◽  
Medial Meniscus ◽  
Human Knee ◽  
Horizontal Cleavage Tear

MRI Analysis of Anteroposterior Stability in the Normal Human Knee

2009 ◽  
Author(s):  
Sally Arno ◽  
Rachel Forman ◽  
Philip Glassner ◽  
Ravinder Regatte ◽  
Peter S. Walker
Keyword(s):  
Shear Force ◽  
Medial Meniscus ◽  
Sagittal Plane ◽  
The Body ◽  
Lateral Side ◽  
Human Knee ◽  
Medial Side ◽  
Normal Human ◽  
Femoral Rollback ◽  
High Range

During activities the knee experiences compressive forces caused by the weight of the body and muscle forces. However, there is also an anterior shear force pushing the femur forwards on the tibia. It is likely to be important to the feeling of stability that the shear force is resisted so as to limit the anterior femoral displacement. The dished bearing surface of the medial tibial compartment in combination with the medial meniscus may well perform this function. In contrast, the lateral tibial surface is convex in the sagittal plane and the meniscus is too mobile to offer any anteroposterior (AP) restraint. Therefore, we hypothesize that if an anterior or posterior force is applied to the femur relative to the tibia, AP stability is provided by the medial side, while the lateral side allows for femoral rollback to facilitate a high range of flexion. At any flexion angle, rotational laxity will occur about a point on the medial side.

Contact mechanics after mattress suture repair of medial meniscus vertical longitudinal tear: an in vitro study

2020 ◽  
Vol 140 (9) ◽  
pp. 1221-1230
Author(s):  
Zhong Chen ◽  
Haozhi Zhang ◽  
Huan Luo ◽  
Rui Yang ◽  
Zhengzheng Zhang ◽  
...  
Keyword(s):  
Contact Mechanics ◽  
Medial Meniscus ◽  
In Vitro Study ◽  
Vitro Study ◽  
Suture Repair ◽  
Mattress Suture ◽  
Longitudinal Tear

scholarly journals Biomechanical Effects of Peripheral Stabilization for the Extruded Medial Meniscus and its Effect on Tibiofemoral Contact Biomechanics

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0024
Author(s):  
Blake T. Daney ◽  
Joseph J. Krob ◽  
Zachary S. Aman ◽  
Hunter W. Storaci ◽  
Alex W. Brady ◽  
...  
Keyword(s):  
Contact Mechanics ◽  
Tibial Plateau ◽  
Medial Meniscus ◽  
Posterior Border ◽  
Meniscal Extrusion ◽  
Full Extension ◽  
Anatomic Repair ◽  
Pull Out ◽  
Stabilization Technique ◽  
Repair Techniques

Objectives: To quantitatively evaluate the biomechanical effects of a novel peripheral stabilization technique for the treatment of posterior medial meniscus root (PMMR) avulsions and to identify an optimal diagnostic position to assess for the presence of meniscal extrusion. Methods: Meniscal extrusion and tibiofemoral contact mechanics were measured using 3D digitization and pressure sensors, respectively, in ten nonpaired, human cadaver knees. The PMMR of each knee was tested under 6 states: (1) intact; (2) complete root detachment; (3) anatomic transtibial pull-out root repair; (4) anatomic transtibial pull-out repair with peripheral stabilization; (5) nonanatomic transtibial pull-out repair; and (6) nonanatomic transtibial pull-out repair with peripheral stabilization, with randomization of the order of conditions 3 & 4, and 5 & 6. The testing protocol loaded knees with a 1000 N axial compressive force at four flexion angles (0°, 30°, 60°, 90°) in each state. Meniscal extrusion was recorded at 0° and 90° in both loaded and unloaded states at three locations along the peripheral rim of the medial tibial plateau. Degree of meniscal extrusion was defined as the radial displacement of the medial meniscus from three corresponding points on the posteromedial edge of the tibial plateau: (1) posterior border of MCL; (2) posteromedial capsule midway between the MCL and posterior root; and (3) the direct posterior capsule. Peak contact pressure, contact area, and total contact pressure were also recorded for all states at all flexion angles. Results: Statistical analysis investigated the independent effects of flexion, state, and loading using three, distinct two-factor models. In unloaded knees in full extension, the highest degree of meniscal extrusion was observed at the posterior border of the MCL across all repair testing states (p < 0.001). At full extension, loaded knees exhibited significantly higher extrusion in comparison to unloaded across all knee states at the MCL position (mean 1.1 mm, 95% CI [0.8, 1.4], p <0.001). Significantly more extrusion was observed at 90° of flexion (mean 0.7 mm, 95% CI [0.36, 1.1], p < 0.001). In loaded knees at 90° of flexion, all repair states had significantly lower extrusion than the root tear state (all p <0.05). Only anatomic repair with peripheral stabilization had significantly lower extrusion than both nonanatomic repairs with or without peripheral stabilization (both p < 0.01). Differences in the contact mechanics between repair techniques were most notable at higher flexion angles, demonstrating significantly higher average and peak contact pressures for non-anatomic repair variations when compared to anatomic repairs with and without peripheral stabilization (all p <0.05). Root tear states were significantly higher than intact states for all comparisons except for peak pressure at 0° of flexion (all p < 0.01). Conclusion: Anatomic and anatomic with peripheral suture repair techniques best restore contact mechanics of the knee. In current clinical scenarios where knees are unloaded and imaged in full extension, extrusion is best measured in the coronal plane at the posterior border of the MCL. However, this is likely a “best-case” scenario, as this study has shown that the degree of extrusion increases as the knee is loaded and flexed to 90°. When only a non-anatomic repair can be performed the addition of this peripheral stabilization technique may be beneficial for patients in reducing pathologic extrusion of the meniscus. [Table: see text]

Discoid medial meniscus with a horizontal cleavage tear

2012 ◽  
Vol 21 (5) ◽  
pp. 425-427 ◽  
Author(s):  
Jingqing Chen ◽  
Shijun Gao ◽  
Baicheng Chen
Keyword(s):  
Medial Meniscus ◽  
Discoid Medial Meniscus ◽  
Horizontal Cleavage Tear

scholarly journals Tibiofemoral Contact Mechanics With Horizontal Cleavage Tears and Treatment of the Lateral Meniscus in the Human Knee

2018 ◽  
Vol 476 (11) ◽  
pp. 2262-2270 ◽  
Author(s):  
Jason L. Koh ◽  
Todd A. Zimmerman ◽  
Savan Patel ◽  
Yupeng Ren ◽  
Dali Xu ◽  
...  
Keyword(s):  
Contact Mechanics ◽  
Lateral Meniscus ◽  
Human Knee

Studies on the innervation of the medial meniscus in the human knee joint

1969 ◽  
Vol 165 (4) ◽  
pp. 485-491 ◽  
Author(s):  
A. S. Wilson ◽  
P. G. Legg ◽  
J. C. McNeur
Keyword(s):  
Knee Joint ◽  
Medial Meniscus ◽  
Human Knee ◽  
Human Knee Joint

scholarly journals Tibiofemoral Contact Mechanics with Horizontal CleavageTears and Resection of the Lateral Meniscus in the Human Knee

2017 ◽  
Vol 5 (7_suppl6) ◽  
pp. 2325967117S0034
Author(s):  
Jason L. Koh ◽  
Todd A. Zimmerman ◽  
Savan Patel ◽  
Yupeng Ren ◽  
Jongsang Son ◽  
...  
Keyword(s):  
Contact Mechanics ◽  
Lateral Meniscus ◽  
Human Knee

scholarly journals Dynamic Contact Mechanics of the Medial Meniscus as a Function of Radial Tear, Repair, and Partial Meniscectomy

2010 ◽  
Vol 92 (6) ◽  
pp. 1398-1408 ◽  
Author(s):  
Asheesh Bedi ◽  
Natalie H Kelly ◽  
Michael Baad ◽  
Alice JS Fox ◽  
Robert H Brophy ◽  
...  
Keyword(s):  
Contact Mechanics ◽  
Medial Meniscus ◽  
Dynamic Contact ◽  
Partial Meniscectomy ◽  
Radial Tear
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