Related Experiment Video
Updated: May 7, 2025
Subject-specific Musculoskeletal Model for Studying Bone Strain During Dynamic Motion
Published on: April 11, 2018
Meniscal forces and knee kinematics are affected by tibial slope modifying high tibial osteotomy
Philipp W Winkler1,2,3, Calvin K Chan1, Sene K Polamalu1
1Orthopaedic Robotics Laboratory, Departments of Bioengineering and Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Purpose:
To quantify the effect of increasing the posterior tibial slope (PTS) on knee kinematics and the resultant medial and lateral meniscal forces.
Methods:
In this controlled laboratory study, a 6 degrees of freedom (DOF) robotic testing system was used to apply external loading conditions to seven fresh-frozen human cadaveric knees: (1) 200-N axial compressive load, (2) 5-N m internal tibial +10-N m valgus torque and (3) 5-N m external tibial + 10-N m varus torque. Knee kinematics and the resultant medial and lateral meniscal forces were acquired for two PTS states: (1) native PTS and (2) increased PTS. Resultant forces in the medial and lateral meniscus were calculated using the principle of superposition.
Results:
In response to 5-N m external tibial + 10-N m varus torque, significantly more internal tibial rotation was observed after increasing PTS at 60° (p = 0.0156) and 90° (p = 0.0156) flexion. Increasing PTS caused significantly more medial tibial translation from 30° to 90° flexion in response to 5-N m internal tibial + 10-N m valgus torque. In response to 5-N m external tibial + 10-N m varus torque, the resultant force in the medial meniscus at 60° flexion decreased significantly after increasing PTS (32.8%, p = 0.016). Resultant forces in the lateral meniscus decreased significantly after increasing PTS at 30° (34.5%; p = 0.016) and 90° (29.7%; p = 0.031) flexion in response to 5-N m internal tibial + 10-N m valgus torque.
Conclusion:
Increasing PTS in a native knee with intact cruciate ligaments affected 6 DOF knee kinematics and decreased resultant forces in the medial and lateral meniscus by up to 35% in response to combined rotatory loads. Therefore, increasing PTS during high tibial osteotomy in a knee with intact cruciate ligaments does not increase the force carried by the entire meniscus at time zero.
Level Of Evidence:
N/A.
