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Destabilization of the Medial Meniscus and Cartilage Scratch Murine Model of Accelerated Osteoarthritis

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Does simulated walking cause gapping of meniscal repairs?

Patrick C McCulloch¹, Hugh L Jones², Kendall Hamilton^3,4

¹Methodist Center for Sports Medicine, Houston Methodist Hospital, Houston, TX, USA. pcmcculloch@houstonmethodist.org.

Journal of Experimental Orthopaedics

|March 17, 2016

Summary

Physiologic gait loading causes compression, not gapping, in repaired medial meniscus tears. While the meniscus translated posteriorly during gait, repair did not fully restore normal motion.

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Area of Science:

Orthopedic surgery
Biomechanics
Sports medicine

Background:

Rehabilitation after meniscal repair aims to balance healing with preserving joint function.
Both protective and accelerated rehabilitation protocols have shown success.
This study investigates the kinematic effects of physiologic gait loading on repaired medial menisci.

Purpose of the Study:

To assess the impact of simulated physiologic gait loading on the kinematic behavior of repaired medial menisci.
To compare the meniscal motion in intact, torn, and repaired states.

Main Methods:

Eight fresh cadaveric knees were used.
Bead arrays were implanted into medial menisci for motion tracking.
Simulated gait stance phase with pneumatic actuators applied muscle loads and forces.
Biplanar radiography and RSA measured meniscus motion at key gait phases (loading response, mid-stance, toe-off).

Main Results:

The tissue at the longitudinal tear site consistently compressed, rather than gapped, in all states (intact, torn, repaired).
Posterior meniscus horn compression varied across states but showed no significant difference (p > 0.15).
The entire meniscus exhibited posterior translation during the gait cycle, which was greatest in the torn state and not fully restored after repair.

Conclusions:

Repaired longitudinal medial meniscal tears experience compression during simulated gait.
Meniscal repair did not fully restore normal posterior translation during simulated gait.