Femoro‐tibial and menisco‐tibial translation patterns in patients with unilateral anterior cruciate ligament deficiency—a potential cause of secondary meniscal tears

Abstract

Objectiur: To analyze menisco-tibia1 and femoro-tibia1 translation patterns in healthy and ACL-deficient knees in different knee flexion angles under muscle activity.Methods: The ACL-deficient and contralateral healthy knees of 10 patients were examined with an open MR system at 30" and 90" of knee flexion, under isometric contraction of the extensors or flexor muscle groups. Translations between the tibia, the femoral condyles and the menisci were analyzed by three-dimensional image postprocessing.Results: Posterior translation of the femur and menisci relative to the tibia occurred during knee flexion (30-90") in all knees. In ACL-deficient knees, posterior translation of the medial femoral condyle (+I .3 * 3.8 mm) was significantly larger than in healthy knee (-0.9 k 2.9 mm; p < 0.05), while the translation pattern of the menisci was similar (med. meniscus 0.6 f 2.3 mm vs. 0.6 2 2.7 mm). Under isometric contraction of the extensors (relative to the flexor muscle group), an increased posterior position of the femur and menisci was observed at 30" knee flexion, but not at 90". This applied to ACL-deficient and healthy knees.Conclusions: This study shows a significant increase of translation of the medial femoral condyle in ACL-deficient knees, whereas menisco-tibia1 translation remains almost unchanged. This difference in translation patterns indicates that the posterior horn of the medial meniscus might encounter shear, potentially explaining the high rate of secondary medial meniscal tears in patients with ACL-deficiency.

Is Noncontact ACL Injury Associated with the Posterior Tibial and Meniscal Slope?

“…Therefore, a different MS can be interpreted as a result of the injury rather than a risk factor. We suppose this effect would be low because no differences in meniscotibial translation apparently occur between ACL injured and healthy knees at different flexion angles and muscle activity [49]. There was no radial expansion of the menisci observed until 1000 N axial joint compression [10].…”

Morphometric Differences between the Medial and Lateral Meniscus in Healthy Men – A Three-Dimensional Analysis Using Magnetic Resonance Imaging

“…Functionally, the menisci distribute loads, guide movement, reduce contact stress, and protect the articular cartilage during dynamic and static joint loading [Walker and Erkman, 1975;Kurosawa et al, 1980;Messner and Gao, 1998;Eisenhart-Rothe et al, 2004;Chivers and Howitt, 2009]. The menisci were also reported to have proprioceptive and lubricating functions [Chivers and Howitt, 2009].…”

Injury patterns in patients presenting with a recurrent anterior cruciate ligament tear following primary reconstruction

“…This finding seems to reflect the distribution of meniscus injuries seen in chronically injured ACLs (24)(25)(26)(27)(28). This has been attributed to differences in translation patterns of the medial femoral condyle on the meniscal-tibial plateau in an ACL injured knee as compared to a healthy knee (23,29,30).…”