Relationship between increased in vivo meniscal loads and abnormal tibiofemoral surface alignment in ACL deficient...

The aim of this study was to quantify how abnormal dynamic tibiofemoral surface alignment affects the load bearing function of menisci in vivo. Using a sheep model of ACL deficiency, we tested the hypothesis that increased in vivo meniscal loads correlate with greater tibiofemoral surface alignment abnormality. Stifle kinematics were recorded using a bone-mounted instrumented spatial linkage in four sheep before, and at four and twenty weeks (w) after ACL transection. A parallel robotic manipulator was used to quantify stifle kinetics by reproducing each animal׳s in vivo kinematics and measuring tissue loads during gait. Meniscal resultant loads were estimated from the change in joint reaction force after sequentially removing load-bearing tissues. Tibiofemoral subchondral surfaces were then traced and modeled using thin plate splines. Proximity disturbance is a surface interaction measure used to quantify dynamic tibiofemoral surface alignment abnormality. ACL transection increased meniscal loads by 30-145% at 20w post-ACL transection, whereas the degree of dynamic tibiofemoral subchondral surface alignment varied between sheep. Positive and significant correlations between increased meniscal loads and proximity disturbance values >10mm were observed (R²=0.04-0.57; p≤0.05). Our results suggest that the proximity disturbance measure reflects abnormal meniscal loads following ACL injury; however given the range of R² values, perturbations in dynamic tibiofemoral subchondral surface alignment do not explain abnormal joint kinetics entirely, and point to the presence of other dynamic compensatory mechanisms that may have a significant bearing on in vivo joint function and long-term joint health.