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Comparative Biomechanical Study on Contact Alterations After Lateral Meniscus Posterior Root Avulsion, Transosseous
Ana Perez-Blanca1, Alejandro Espejo-Baena2, Daniel Amat Trujillo3
1Biomechanics Laboratory, Department of Mechanical Engineering, University of Malaga, Malaga, Spain.
Purpose:
To compare the effects of lateral meniscus posterior root avulsion left in situ, its repair, and meniscectomy on contact pressure distribution in both tibiofemoral compartments at different flexion angles.
Methods:
Eight cadaveric knees were tested under compressive 1000 N load for 4 lateral meniscus conditions (intact, posterior root avulsion, transosseous root repair, and total meniscectomy) at flexion angles 0°, 30°, 60°, and 90°. Contact area and pressure distribution were registered using K-scan pressure sensors inserted between menisci and tibial plateau.
Results:
In the lateral compartment, root detachment decreased contact area (P = .017, 0° and 30°; P = .012, 60° and 90°) and increased mean (P = .012, all angles) and maximum (P = .025, 0° and 30°; P = .017, 60°; P = .012, 90°) pressures relative to intact condition. Repair restored all measured parameters close to intact at 0°, but effectiveness decreased with flexion angle, yielding no significant effect at 90°. Meniscectomy produced higher decreases than root avulsion in contact area (P = .012, 0° and 90°; P = .05, 30° and 60°) and increases in mean (P = .017, 0° and 30°; P = .018, 90°) and maximum pressure (P = .012, 0°; P = .036, 30°). In the medial compartment, lesion changed the contact area at high flexion angles only, while meniscectomy induced greater changes at all angles.
Conclusions:
Lateral meniscus posterior root avulsion generates significant alterations in contact area and pressures at lateral knee compartment for flexion angles between full extension and 90°. Meniscectomy causes greater disorders than the avulsion left in situ. Transosseous repair with a single suture restores these alterations to conditions close to intact at 0° and 30° but not at 60° and 90°.
Clinical Relevance:
Altered contact mechanics after lateral meniscus posterior root avulsion might have degenerative consequences. Transosseous repair with one suture should be revised to effectively restore contact mechanics at high flexion angles.
