An anatomical study of meniscal allograft sizing

Abstract

Meniscus-to-femoral condyle congruity is essential for the development of circumferential hoop stresses and thus function of the meniscus. When meniscal allograft transplantation is performed using bony anchorage of the insertional ligaments, accurate graft-to-host size matching is therefore essential. The standard method currently employed for size matching of meniscal allografts is to rely on plain radiographs of the host's knee, from which expected meniscal dimensions are measured. This study aimed to examine the correlation between tibial plateau dimensions and meniscal dimensions. We studied 44 donor tibial plateaus with medial and lateral meniscal allografts attached intact. Meniscal and tibial plateau dimensions were measured. Linear regression analysis was used to calculate expected meniscal dimensions from each specimen's plateau dimensions. Using specific medial and lateral tibial plateau width and length measurements, meniscal dimensions could be predicted with a mean error of only 5.0+/-6.4%. When predicting meniscal dimensions from only total bony plateau width, the mean error observed was 6.2+/-8.0%. The difference between the two methods was not statistically significant. The results suggest that meniscal dimensions can be predicted accurately from tibial plateau measurements, with only small mean errors. However, potential size mismatches should be carefully borne in mind by surgeons using meniscal allografts.

Morphometric Analysis of the Menisci of the Knee Joint in Population of East Godavari Region of Andhra Pradesh

“…[12] Kohn and Moreno [9] reports that, if bony fixation of a meniscal substitute should be attempted, the entire circumferential length of the meniscus plus both the insertion ligaments must be known. This length in the adult menisci has been described previously by Kohn & Moreno [9] and McDermott et al [13] Cadaveric dissection can help in sizing the grafts accurately; hence, it is interesting to correlate the allograft sizing with dimensions of cadaveric menisci.…”

Postoperative change in medial meniscal length in concurrent all-inside meniscus repair with anterior cruciate ligament reconstruction

“…Several variables, such as patient height and weight and radiographic measurements of the medial tibial plateau are considered good candidates for determining medial meniscal size [25]. Height has linear [15]. In our study, height had a poorer correlation with MML than with MMW preoperatively and postoperatively.…”

“…Medial tibial plateau length (MTPL) was measured from the maximum AP dimension of the medial plateau in a radiographic lateral view [14,15]. Anteroposterior radiography was used to measure medial tibial plateau width (MTPW) by obtaining the distance from the medial margin of the tibial plateau to the peak of the medial intercondylar eminence [14,15].…”

“…Anteroposterior radiography was used to measure medial tibial plateau width (MTPW) by obtaining the distance from the medial margin of the tibial plateau to the peak of the medial intercondylar eminence [14,15]. Imaging evaluation was performed using an Achieva 1.…”

An Optical Method for Evaluation of Geometric Fidelity for Anatomically Shaped Tissue-Engineered Constructs

“…22 Here we focus on the generation of anatomically accurate engineered menisci. The meniscus is pertinent for three reasons: (1) clinical relevance-meniscal lesions are one of the most common injuries in the knee 23 with >1.5 million knee surgeries involving the meniscus and usually resulting in the removal of damaged tissue as opposed to repair or replacement 23 ; (2) complex geometrypredicting and calculating meniscal shape based on magnetic resonance imaging (MRI) images can be quite time consuming, and the algorithms for making these predictions are continually being modified [24][25][26][27][28] ; (3) accurate meniscal geometry is crucial for proper mechanical function of the knee joint, 29 its primary function being to aid in joint load distribution, thus decreasing contact stresses on the underlying articular cartilage. A deviation by >10% in size matching 27 can result in detrimental joint loading and more rapid development of osteoarthritis.…”