Partial resection of lateral discoid meniscus changes lower limb axial alignment – A retrospective cohort study

He, Yao; Chen, Hong; Fan, Yuanjun; Zhou, Yinghao; Wang, Bao

doi:10.1016/j.knee.2022.06.010

Cited by 9 publications

(6 citation statements)

References 39 publications

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“…Due to the thicker discoid meniscus, discoid meniscectomy creates a significant gap in the outer joint space, altering the knee joint's biomechanical stress distribution. Several follow-up studies have reported complications such as secondary knee degeneration, posterolateral instability of the knee joint, and knee valgus [ 25 – 27 ]resulting from discoid meniscectomy. Therefore, preserving an adequate width of the remaining peripheral edge of the discoid lateral meniscus is crucial.…”

Section: Discussionmentioning

confidence: 99%

Effect of residual volume after surgery of the discoid lateral meniscus on tibiofemoral joint biomechanics: a finite element analysis

Shen,

Lu,

Liu

et al. 2024

J Orthop Surg Res

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Background The purpose of this study was to investigate the influence of different residual meniscus volume on the biomechanics of tibiofemoral joint after discoid lateral meniscus (DLM) surgery by finite element analysis. Methods A knee joint model was established based on CT and MRI imaging data. The DLM model was divided into five regions according to conventional meniscectomy, with volumes of 15%, 15%, 15%, 15%, 15%, and 40% for each region. Additionally, the DLM model was divided into anterior and posterior parts to obtain ten regions. The DLM was resected according to the design scheme, and together with the intact discoid meniscus, a total of 15 models were obtained. Finite element analysis was conducted to assess shear and pressure trends on the knee joint. Results The study observed significant changes in peak shear stress and compressive stress in the lateral meniscus and lateral femur cartilage. As the meniscus volume decreased, there was an increase in these stresses. Specifically, when the meniscus volume reduced to 40%, there was a sharp increase in shear stress (302%) and compressive stress (152%) on the meniscus, as well as shear stress (195%) and compressive stress (157%) on the lateral femur cartilage. Furthermore, the model grouping results showed that preserving a higher frontal volume in the meniscus model provided better biomechanical advantages. Conclusion The use of finite element analysis has demonstrated that preserving more than 55% of the meniscus volume is necessary to prevent a significant increase in joint stress, which can potentially lead to joint degeneration. Additionally, it is crucial to preserve the front volume of the DLM in order to achieve improved knee biomechanical outcomes.

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Section: Discussionmentioning

confidence: 99%

Effect of residual volume after surgery of the discoid lateral meniscus on tibiofemoral joint biomechanics: a finite element analysis

Shen,

Lu,

Liu

et al. 2024

J Orthop Surg Res

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“…Due to these factors, discoid menisci are more vulnerable to tearing and developing spontaneous symptoms of locking, pain, and effusion [45]. Furthermore, these factors increase the degenerative changes seen in even juvenile patients [21]. Additionally, these factors increase the difficulty of discoid procedures and impact pre‐operative planning as not even magnetic resonance imaging is sufficient in predicting the reparability of the lateral discoid meniscus during arthroscopy [61].…”

Section: Discussionmentioning

confidence: 99%

Patients with discoid menisci have similar clinical outcomes to those without discoid menisci when undergoing surgical intervention: a systematic review

Diao

Vivekanantha

Cohen

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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PurposeTo compare post‐operative clinical outcomes of discoid meniscus tear procedures such as saucerization with or without repair with those of non‐discoid meniscus tears such as meniscectomy or repair in skeletally mature patients with no concomitant injuries. MethodsThree databases MEDLINE, PubMed and EMBASE were searched from inception to July 3rd, 2022 for literature describing patient‐reported outcome measures after meniscus surgery in discoid or non‐discoid meniscus tears. The authors adhered to the PRISMA and R‐AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Clinical outcome data on Lysholm, Tegner, International Knee Documentation Committee (IKDC), revision rates, and complications were recorded, with MINORS and Detsky scores used for quality assessment. ResultsA total of 38 studies comprising 2213 patients were included with a mean age of 38.6 years (range: 9.0–64.4). The mean follow‐up time was 54.1 months (range: 1–234) and the average percentage of female participants was 46.8% (range: 9.5–95.5). The mean change between pre‐operative and post‐operative Lysholm scores ranged from 21.0–39.0, 7.4–24.1, and 24.2–48.4 in the discoid, non‐discoid meniscectomy, and non‐discoid repair groups, respectively. The mean change in Tegner scores ranged from 0.0 to 2.3, 1.3, and 0.4–1.3 in the discoid, non‐discoid meniscectomy, and non‐discoid repair groups, respectively. Pre‐operative IKDC scores were not reported, however mean post‐operative IKDC scores ranged from 77.4 to 96.0, 46.9 to 85.7, and 63.1 to 94.0 in discoid, non‐discoid meniscectomy, and non‐discoid repair groups, respectively. Revision rates for discoid procedures, non‐discoid meniscectomies, and non‐discoid meniscus repairs ranged from 3.2 to 44.0%, 8.3 to 56.0%, and 5.9 to 28.0%, respectively. The most common reasons for revision were acute trauma and persistent pain. ConclusionDiscoid saucerization procedures with or without repair leads to similar Lysholm scores as non‐discoid repair procedures, and similar IKDC scores and revision rates compared to non‐discoid meniscectomy or repair procedures. Patients undergoing discoid procedures appeared to have slightly higher Tegner activity scores compared to patients undergoing non‐discoid procedures; however this is to be considered in the context of a younger population of patients undergoing discoid procedures than non‐discoid procedures. This information can help guide surgeons in the decision‐making process when treating patients with discoid menisci, and should guide further investigations on this topic. Level of evidenceIV.

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“…In addition, ankle flexion showed a greater ROM, which may also be affected due to the compensatory decrease in hip flexion to keep the lower limbs in the relative position during gait cycles ( Le Huec et al, 2019 ). Likewise, to maintain global balance and keep the trunk erect, patients with TLK have to increase the degree of knee flexion and ankle extension correspondingly ( Matsumura et al, 2020 ; Chau et al, 2021 ; He et al, 2022 ). According to previous studies, long-term abnormal ROM and stress of lower limb joints, as well as a long-term strain of muscles around the joints, often lead to the emergence and aggravation of osteoarthritis ( Le Huec et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…This can be explained as the patients subconsciously becoming more careful during the gait pattern, leading to greater lower limb muscle tension because of the unconscious fear of falling ( Lafond et al, 2004 ; Sinaki et al, 2005 ; Pataky, 2012 ; Xia et al, 2018 ). Ultimately, the long-term compensation of lower limbs results in the concentration of abnormal stress on the joints, which may lead to or accelerate the degeneration of joints ( Matsumura et al, 2020 ; He et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Impacts of gait biomechanics of patients with thoracolumbar kyphosis secondary to Scheuermann’s disease

Cheng

Jiang

Chen

et al. 2023

Front. Bioeng. Biotechnol.

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Introduction: Thoracolumbar kyphosis (TLK) is a common feature in patients with spinal deformities. However, due to limited studies, the impacts of TLK on gait have not been reported. The objective of the study was to quantify and evaluate the impacts of gait biomechanics of patients with TLK secondary to Scheuermann’s disease.Methods: Twenty cases of Scheuermann’s disease patients with TLK and twenty cases of asymptomatic participants were recruited into this study. And the gait motion analysis was conducted.Results: The stride length was shorter in the TLK group compared to control group (1.24 ± 0.11 m vs. 1.36 ± 0.21 m, p = 0.04). Compared to control group, the stride time and step time were more prolonged in the TLK group (1.18 ± 0.11s vs. 1.11 ± 0.08 s, p = 0.03; 0.59 ± 0.06 s vs. 0.56 ± 0.04 s, p = 0.04). The gait speed of the TLK group was significantly slower than it of control group (1.05 ± 0.12 m/s vs. 1.17 ± 0.14 m/s, p = 0.01); In the sagittal plane, the range of motion (ROM) of the hip in the TLK group was significantly smaller than that of the control group (37.71 ± 4.35° vs. 40.05 ± 3.71°, p = 0.00). In the transverse plane, the adduction/abduction ROMs of the knee and ankle, as well as the internal and external rotation of the knee, were smaller in TLK group than ROMs in the control group (4.66 ± 2.21° vs. 5.61 ± 1.82°, p = 0.00; 11.48 ± 3.97° vs. 13.16 ± 5.6°, p = 0.02; 9.00 ± 5.14° vs. 12.95 ± 5.78°, p = 0.00).Discussion: The main finding of this study was that measurements of gait patterns and joint movement of the TLK group were significantly lower than those of the control group. And these impacts have the potential to exacerbate degenerative progress of joints in the lower extremities. These abnormal features of gait can also serve as a guideline for physicians to focus on TLK in these patients.

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Partial resection of lateral discoid meniscus changes lower limb axial alignment – A retrospective cohort study

Cited by 9 publications

References 39 publications

Effect of residual volume after surgery of the discoid lateral meniscus on tibiofemoral joint biomechanics: a finite element analysis

Effect of residual volume after surgery of the discoid lateral meniscus on tibiofemoral joint biomechanics: a finite element analysis

Patients with discoid menisci have similar clinical outcomes to those without discoid menisci when undergoing surgical intervention: a systematic review

Impacts of gait biomechanics of patients with thoracolumbar kyphosis secondary to Scheuermann’s disease

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