Is it important to secure the horns during lateral meniscal transplantation? A cadaveric study

The purpose of this investigation was to determine if secure attachment of the horns of the lateral meniscus during transplantation affects the load-bearing function of the meniscus. Six knee joints were loaded in compression (310 N) and the interarticular contact pressure in the joint measured using pressure-sensitive film inserted into the joint. Each knee was tested first with the original intact meniscus and then after each of the following surgical procedures involving the original lateral meniscus: (1) total meniscectomy; (2) meniscal transplantation with a tibial bone bridge; (3) meniscal transplantation with neither horn secured; (4) meniscal transplantation with the anterior horn secured; (5) meniscal transplantation with the posterior horn secured; and (6) meniscal transplantation with both horns secured. The results are as follows. (1) The intact joint gave the largest contact area and the smallest peak contact pressure. The joint with the total meniscectomy gave the smallest contact area and the largest peak contact pressure. (2) A meniscal transplantation with either a tibial bony bridge or with both horns secured gave results similar to those for the intact joint. (3) A meniscal transplantation with only one horn secured gave results somewhere in between those for the intact joint and those for the joint without a meniscus. A meniscal transplantation with neither horn secured gave results similar to those for a joint without a meniscus.