Function of the medial meniscus in force transmission and stability

Walker, Peter S.; Arno, Sally; Bell, Christopher; Salvadore, G.; Borukhov, Ilya; Oh, Cheongeun

doi:10.1016/j.jbiomech.2015.02.055

Cited by 90 publications

(61 citation statements)

References 24 publications

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“…Under physiologic conditions, the medial meniscus carries between 40% and 80% of the load in the medial compartment of healthy knee [3]. The way the meniscus contributes to the force transmission in varus OA knee and cartilage degeneration remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Thanks to the predominant circumferential orientation of the collagen fibres in the menisci, they counteract extrusion and direct tensile forces along their axis. For vertical compression they carry between 44% and 78% of the load, reducing the mechanical stresses on cartilage surfaces [3]. It is well accepted that the loss of meniscal integrity may reduce radial stiffness and cause radial displacement, which is significantly associated with increased peak tibiofemoral contact stress and cartilage degeneration [4,5].…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Articular Cartilage Thickness Reduction on Meniscus Biomechanics

et al. 2016

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ObjectiveEvaluation of the biomechanical interaction between meniscus and cartilage in medial compartment knee osteoarthritis.MethodsThe finite element method was used to simulate knee joint contact mechanics. Three knee models were created on the basis of knee geometry from the Open Knee project. We reduced the thickness of medial cartilages in the intact knee model by approximately 50% to obtain a medial knee osteoarthritis (OA) model. Two variants of medial knee OA model with congruent and incongruent contact surfaces were analysed to investigate the influence of congruency. A nonlinear static analysis for one compressive load case was performed. The focus of the study was the influence of cartilage degeneration on meniscal extrusion and the values of the contact forces and contact areas.ResultsIn the model with incongruent contact surfaces, we observed maximal compressive stress on the tibial plateau. In this model, the value of medial meniscus external shift was 95.3% greater, while the contact area between the tibial cartilage and medial meniscus was 50% lower than in the congruent contact surfaces model. After the non-uniform reduction of cartilage thickness, the medial meniscus carried only 48.4% of load in the medial compartment in comparison to 71.2% in the healthy knee model.ConclusionsWe have shown that the change in articular cartilage geometry may significantly reduce the role of meniscus in load transmission and the contact area between the meniscus and cartilage. Additionally, medial knee OA may increase the risk of meniscal extrusion in the medial compartment of the knee joint.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Influence of Articular Cartilage Thickness Reduction on Meniscus Biomechanics

et al. 2016

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“…The zone of transition from the body of the meniscus to the attachment site appears to have a lower strength than the body of the meniscus or the site of attachment (Freutel et al, 2015b). Walker et al (2015) used a cadaveric model to demonstrate that the anterior horn experienced its highest loads at low flexion angles with the addition of shear forces, while the posterior horn carried the highest percentage of load overall at higher flexion angles with a posterior shear force. Guess et al (2015) combined imaging with motion capture data from two healthy subjects to show that relatively small changes in the length of the attachment at which the horn bundles first become taut, manifested large changes in the ability of the meniscus to transmit forces.…”

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confidence: 99%

Meniscus mechanics and mechanobiology

Donahue

Fisher

Maher

2015

Journal of Biomechanics

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“…Walker et al 6 suggested that on the medial side of the knee, the load is shared approximately equally between the meniscus and exposed cartilage, whereas the lateral meniscus carries most of the load on the lateral side of the knee joint. Biomechanical studies have found that the maximal tibiofemoral contact pressures are located in the posterior region of the medial meniscus (with average values of 2.9 MPa) and in the anterior horn of the lateral meniscus (1.45 MPa).…”

Section: Discussionmentioning

confidence: 99%

“…The anterior horn of the medial meniscus has been reported to be particularly important for stabilizing external rotation when the knee is fully extended 5 as well as preventing anterior femoral displacement. 6 Commonly used techniques for meniscal repair include inside-out, outside-in, and all-inside techniques. Of these, the outside-in repair technique is ideal for anterior horn tears because it allows for adequate access to the anterior horn of the meniscus, provides a stable fixation construct, and avoids leaving prominent intra-articular material.…”

mentioning

confidence: 99%

Anterior Horn Meniscal Repair Using an Outside-In Suture Technique

Menge

Dean

Chahla

et al. 2016

Arthroscopy Techniques

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The menisci are important structures within the knee that play a critical role in maintaining proper stability, load distribution, and joint lubrication. Injury to the menisci has been found to significantly alter the complex biomechanics of the knee, and thus affect the health and longevity of the native joint. Tears involving the anterior horn are increasingly recognized as an important pathology. Although early treatment of meniscal tears focused primarily on removal of the injured tissue, recent attention on the long-term consequences of partial or total meniscectomy has led to increased attempts at meniscus repair whenever possible. Because of the location of anterior horn tears and the technical difficulty in accessing this location arthroscopically, an outside-in repair technique is ideal for treatment of these lesions. This technical note details our surgical technique of outside-in repair of anterior horn meniscal tears.

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Function of the medial meniscus in force transmission and stability

Cited by 90 publications

References 24 publications

The Influence of Articular Cartilage Thickness Reduction on Meniscus Biomechanics

The Influence of Articular Cartilage Thickness Reduction on Meniscus Biomechanics

Meniscus mechanics and mechanobiology

Anterior Horn Meniscal Repair Using an Outside-In Suture Technique

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