Influence of Menisci on Tibiofemoral Contact Mechanics in Human Knees: A Systematic Review

Abstract

Purpose: Menisci transfer axial loads, while increasing the load-bearing tibiofemoral contact area and decreasing tibiofemoral contact pressure (CP). Numerous clinical and experimental studies agree that an increased CP is one predominant indicator for post-traumatic osteoarthritis (PTOA) of the knee joint. However, due to the immense variability in experimental test setups and wide range of treatment possibilities in meniscus surgery, it is difficult to objectively assess their impact on the CP determination, which is clearly crucial for knee joint health. Therefore, the aim of this systematic review is to investigate the influence of different meniscal injuries and their associated surgical treatments on the CP. Secondly, the influence of different test setups on CP measurements is assessed. On the basis of these results, we established the basis for recommendations for future investigations with the aim to determine CPs under different meniscal states.Methods: This review was conducted in accordance with the PRISMA guidelines. Studies were identified through a systematic literature search in Cochrane, PubMed and Web of Science databases. Literature was searched through pre-defined keywords and medical subject headings.Results: This review indicates a significant increase of up to 235% in peak CP when comparing healthy joints and intact menisci with impaired knee joints, injured or resected menisci. In addition, different test setups were indicated to have major influences on CP: The variety of test setups ranged from standard material testing machines, including customized setups via horizontal and vertical knee joint simulators, through to robotic systems. Differences in applied axial knee joint loads ranged from 0 N up to 2,700 N and resulted unsurprisingly in significantly different peak CPs of between 0.1 and 12.06 MPa.Conclusion: It was shown that untreated traumatic meniscal tears result in an increased CP. Surgical repair intervention were able to restore the CP comparable to the healthy, native condition. Test setup differences and particularly axial joint loading variability also led to major CP differences. In conclusion, when focusing on CP measurements in the knee joint, transparent and traceable in vitro testing conditions are essential to allow researchers to make a direct comparison between future biomechanical investigations.

Biomechanical effects of medial meniscus radial tears on the knee joint during gait: A concurrent finite element musculoskeletal framework investigation

“…Of these, even though the presence of an 83% width tear of the posterior horn during the preswing resulted in the most significant increase in cartilage load, the cartilage/total load ratio increased by only 9%. The findings suggested that medial meniscus radial tears have lesser influence on the tibial cartilage loading ( Figure 5 ), consistent with previous experimental results ( Bedi et al, 2010 ; Bedi et al, 2012 ), however, some studies have also concluded that meniscal tears lead to increased cartilage loading ( Zhang et al, 2015 ; Sukopp et al, 2021 ). Previously, investigators have pointed out that meniscal tears in a healthy knee may ultimately lead to the occurrence of knee OA due to the loss of much of the meniscal functionality, such as circumferential stress transmission ( Englund et al, 2009 ).…”

X-Ray Characteristics of the Knee Joints in Patients With Monogonathrosis

“…У разі конгруентних суглобових поверхонь суглобовий хрящ розцінюється як незначний амортизатор, так як товщина суглобового хряща становить 1-4 мм. З цієї точки зору важливішими є меніски, які заповнюють суглобову щілину у різні фази руху [15]. Однак функція гіалінового хряща й менісків, як і зв'язок з сухожилко-м'язовим апаратом, є недостатньою при наявності або виникненні внутрішньосуглобової деформації кістки [16].…”

Autologous semitendinosus meniscus graft restores the native knee joint kinematics and the tibiofemoral contact

“…A recent review on the impact of different test setups and meniscal states on the tibiofemoral contact pressure indicated a major impact of the applied axial load on the CPpeak [47]. The CPpeak measurements of the present study were in the same range of those reported in the intact state and after performing a total LMM under an applied axial loading of 200 N. In their MAT study, Paletta et al [35] applied 1,800 N axial loading and showed a CPpeak increase of up to 335% after LMM compared to the intact meniscus state.…”