Is it important to secure the horns during lateral meniscal transplantation? A cadaveric study

Chen, Michael I.; Branch, Thomas P.; Hutton, William

doi:10.1016/s0749-8063(96)90007-9

Cited by 223 publications

(170 citation statements)

References 18 publications

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“…Since meniscal attachments are important for meniscal function 5,12,24 the description of meniscal attachment microstructure and composition could prove beneficial in the development of tissue-engineered menisci. Not only is the external ligamentous portion and bony insertions important, but future studies should consider the transition from a triangular fibrocartilage in the main body of the meniscus, to the mostly rectangular external ligamentous portion of the attachment.…”

Section: Discussionmentioning

confidence: 99%

“…39 Previous experimental and theoretical studies have shown that meniscal attachment strength affects meniscal stability and function. 5,12,22,24 Anchoring the menisci at the anterior and posterior horns, the meniscal attachments are primarily composed of Type I collagen fibrils extending from the main body of the meniscus into the tibial plateau. 33 The attachments are often referred to as insertional ligaments.…”

Section: Introductionmentioning

confidence: 99%

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A Quantitative Study of the Microstructure and Biochemistry of the Medial Meniscal Horn Attachments

Villegas

Hansen

Liu³

et al. 2007

Ann Biomed Eng

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Abstract-Little quantitative data is available on the structure of meniscal attachments. Therefore, as an aid to designing meniscal replacements as well as a possible explanation for mechanical behavior, this study was designed to further the knowledge of the microstructure and biochemistry of native meniscal attachments. Bovine medial meniscal attachments (the external ligamentous portion as well as the transition zones at the bony insertion) were removed and prepared for microstructural evaluation. After embedding in paraffin, the samples were sliced on a microtome and stained for quantitative analysis. The anterior and posterior insertion sites are known to contain three zones: subchondral bone, calcified fibrocartilage, and uncalcified fibrocartilage. Additionally, others have shown that the anterior insertion site contains a ligamentous zone. The insertion zones were further divided into proximal, middle, and distal zones. The posterior attachment's insertion site had a significantly greater thickness of interdigitations, subchondral bone, uncalcified fibrocartilage, and calcified fibrocartilage zone thickness compared to the anterior attachment insertion. The anterior attachment's insertion had the greatest GAG fraction in each zone when compared to the posterior attachment's insertion. GAG fraction decreased from the meniscus to the subchondral bone. Both GAG fraction and normalized thickness varied within a given zone, decreasing from the distal to proximal regions in both the anterior and posterior attachments' insertion zones. Crimp frequency of the collagen fibrils in the external ligamentous portion of the tissue was homogeneous along the length. The findings from this study agree with previously published material property data on the medial meniscal attachments, and could be used in the future to design methods of attachment for tissue engineered replacement menisci.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Quantitative Study of the Microstructure and Biochemistry of the Medial Meniscal Horn Attachments

Villegas

Hansen

Liu³

et al. 2007

Ann Biomed Eng

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“…Several in vitro biomechanical studies on human cadaveric knees have shown that, for both the medial and the lateral meniscus, bone-plug fixation provides better strength than does soft-tissue fixation [8][9][10][11] . However, the authors of these studies did not take into account the biomechanical behavior after the allograft had healed to the meniscal rim.…”

Section: Discussionmentioning

confidence: 99%

“…When the meniscus has been completely lost, transplantation of a meniscal allograft has been a therapeutic option with favorable results, in terms of pain reduction and functional improvement, in the medium and long term [4][5][6][7] . These improvements are presumably due to an increase in contact area and thus a decrease in contact peak stress compared with a meniscectomized knee [8][9][10][11] . While decreases in contact stresses can result in pain relief and improved function, there is no reasonable proof that delayed meniscal transplantation prevents or slows cartilage degeneration in either compartment 6,12 .…”

mentioning

confidence: 99%

Transplantation of Viable Meniscal Allograft

Verdonk

Demurie

Almqvist

et al. 2005

The Journal of Bone & Joint Surgery

270

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“…In bony fixation of the medial meniscus, one tunnel drilled in each horn is performed and the bone plugs (with sutures attached to each one) are inserted in each tunnel, and the sutures attached to each plug are tied together in the anterior cortex of the tibia. Some in vitro studies have demonstrated that fixation with bone plugs is better compared to graft fixation without bone plugs in terms of restoration of normal contact mechanics of the knee [62][63][64]. Nonetheless, other biomechanical in vitro studies have demonstrated no differences in mean pullout strength of medial meniscus allograft between both fixation methods [65].…”

Section: Fixation Methodsmentioning

confidence: 99%

Meniscal Allograft Transplantation: Where are we Standing?

Monllau¹,

Alentorn-Geli²,

Pelfort³

et al. 2013

J Transplant Technol Res

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Meniscal allograft transplantation (MAT) is becoming a common procedure in Orthopedic departments worldwide. This procedure has demonstrated good and excellent results in terms of pain relief, improvement in clinical and functional outcomes, return to sports, and patient's satisfaction. However, MAT is not a universally accepted procedure due to its questionable chondroprotective effects and the relatively high rate of complications and/or reoperations. The present short review summarizes the principal indications, contraindications, outcomes, and complications. Also, it covers several controversial topics like graft preservation, graft sizing, graft fixation, results in MAT associated with concomitant procedures, and the role of MAT in the prevention of knee osteoarthritis.

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Is it important to secure the horns during lateral meniscal transplantation? A cadaveric study

Cited by 223 publications

References 18 publications

A Quantitative Study of the Microstructure and Biochemistry of the Medial Meniscal Horn Attachments

A Quantitative Study of the Microstructure and Biochemistry of the Medial Meniscal Horn Attachments

Transplantation of Viable Meniscal Allograft

Meniscal Allograft Transplantation: Where are we Standing?

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