Biomechanical analysis of the centralization procedure for extruded lateral menisci with posterior root deficiency in a porcine model

Ozeki, Nobutake; Koga, Hideyuki; Matsuda, Junji; Kohno, Yuji; Mizuno, Mitsuru; Katano, Harutaka; Tsuji, Kunikazu; Saito, T.; Muneta, Takeshi; Sekiya, Ichiro

doi:10.1016/j.jos.2019.02.015

Cited by 30 publications

(49 citation statements)

References 25 publications

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“…Daney et al, in the only report other than ours [15], measured meniscal extrusion and tibiofemoral contact mechanics at the medial compartment in human cadaveric knees [16]. The anatomic transtibial pull-out root repair and the anatomic transtibial pull-out root repair with centralization suture techniques best restored the contact mechanics of the knee and meniscal extrusion when compared with root tear and nonanatomic repair states.…”

Section: Discussionmentioning

confidence: 87%

“…Since the most extended position is approximately at 30° and the most flexed position is approximately at 90° in a pig knee joint, we first set the flexion angles every 30° between 30° and 90°. We also set 45° because we set that angle in our previous report [15]. Biomechanical analysis was therefore performed at 30°, 45°, 60°, and 90°.…”

Section: Discussionmentioning

confidence: 99%

“…First, as in the previous test, the pig's knee was cut and attached to a custom universal tester. [15].…”

Section: Mechanical Settingsmentioning

confidence: 99%

“…As used in previous studies, a pressure mapping sensor system (Tekscan, Inc., South Boston, Mass.) was used to evaluate the distribution of load bearing capacity for the lateral compartment [15]. The measurements included contact area, maximum contact pressure, and average contact pressure.…”

Section: Contact Area and Force Measurementsmentioning

confidence: 99%

“…The sutures were tied through the border between the meniscus and the remaining capsule attached to the meniscus not to pass the meniscus body; they were then stabilized to the tibia using mattress sutures. For all angles, an axial compressive force of 200 N was applied in each setting [15,18].…”

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confidence: 99%

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The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles

Kubota

Koga

Ozeki

et al. 2020

Preprint

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Background: Meniscal extrusion results in loss of the ability to resist hoop strain and biomechanical overload on the joint articular surface. A centralization technique has been developed to overcome these problems. In this study, we analyzed the biomechanics of the extruded and centralized lateral meniscus (LM) in porcine knee joints at different flexion angles.Methods: Porcine knee joints (n=8) were set in the universal tester and each knee was tested under the following states: 1) intact; 2) extrusion—meniscal extrusion was created by resecting the posterior root of the LM and posterior synovial capsule; and 3) centralization—centralization was performed by two anchors inserted in the lateral tibial plateau. Deviation distance of the meniscus, contact pressure, and contact area in the anterior LM, middle LM, posterior LM, and the contact pressure of the tibial cartilage were evaluated with an axial compressive force of 200 N at knee flexion angles of 30°, 45°, 60°, and 90°.Results: The deviation distance of LM significantly increased in extrusion but was restored to the intact status after centralization at all angles. Both the contact pressure and area significantly decreased in extrusion and were restored after centralization close to the intact status in the anterior and middle LM; in the posterior LM, however, decreased contact pressure and area were not restored after centralization. The contact pressure of the tibial cartilage increased significantly in extrusion but decreased close to the intact status after centralization.Conclusions: This centralization procedure could reduce extrusion of the LM and restore the load-distributing function of the anterior-middle LM. However, the procedure itself could not restore hoop function in cases where the defect lies in the posterior LM.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

“…First, as in the previous test, the pig's knee was cut and attached to a custom universal tester. [15].…”

Section: Mechanical Settingsmentioning

confidence: 99%

Section: Contact Area and Force Measurementsmentioning

confidence: 99%

mentioning

confidence: 99%

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The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles

Kubota

Koga

Ozeki

et al. 2020

Preprint

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Biomechanical analysis of a centralization procedure for extruded lateral meniscus after meniscectomy in porcine knee joints

Kohno

Koga

Ozeki

et al. 2021

Journal Orthopaedic Research

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The recently developed arthroscopic centralization for lateral meniscal extrusion has obtained satisfactory short‐term clinical and radiological results and improves the meniscus biomechanical properties. However, the effectiveness of treatment for meniscus extrusion after partial meniscectomy still requires elucidation. This study investigated the effect of centralization with modifications from a mechanical viewpoint. Porcine knee joints (N = 6) were set in a universal tester under the following conditions: (1) Intact; (2) Meniscectomy: Inner half of the posterior half meniscus was removed; (3) Extrusion: Posterior meniscus was dislocated laterally by transecting the posterior root and the meniscotibial ligament; (4) Centralization‐1: Centralization procedure using one anchor; (5) Centralization‐2: Centralization procedure using two anchors; and (6) Centralization‐ad: Centralization with capsular advancement using two anchors. Load distributions and contact pressure in the meniscus and tibial cartilage were evaluated with an axial compressive force of 200 N. After meniscectomy, the tibial cartilage load increased and that of the medial margin of the posterior part of the meniscus decreased. When the meniscus was extruded, the load was concentrated only on the tibial cartilage. Centralization‐1 increased the load on the meniscus, while Centralization‐2 further increased the meniscus load but decreased the tibial cartilage load. Centralization‐ad further decreased the load on the tibial plateau. The average contact pressure of the tibial cartilage was significantly higher in the Extrusion group than in the Intact group or the Centralization‐ad group. From a biomechanical viewpoint, centralization with capsular advancement was the most effective of the tested procedures for treatment for an extruded meniscus after partial meniscectomy.

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Meniscus Root Tear and Its Treatment

LaPrade

Keyt

Krych

2021

Cartilage Injury of the Knee

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Biomechanical analysis of the centralization procedure for extruded lateral menisci with posterior root deficiency in a porcine model

Cited by 30 publications

References 25 publications

The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles

The effect of a centralization procedure for extruded lateral meniscus on load distribution in porcine knee joints at different flexion angles

Biomechanical analysis of a centralization procedure for extruded lateral meniscus after meniscectomy in porcine knee joints

Meniscus Root Tear and Its Treatment

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