Transmission of the Load in the Knee Joint with Special Reference to the Role of the Menisci

Seedhom, B B

doi:10.1243/emed_jour_1979_008_050_02

Cited by 148 publications

(123 citation statements)

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“…Nevertheless, a 10%) difference in contact variables represents a significant reduction for the changes in the contact variables seen for the meniscectomized knee [2,4,6,19,28]. Peak contact stresses on the lateral and medial articular surfaces of the tibia increase over 300% in the meniscectomized knee [4,19,25,29], and contact areas decrease by 50% [4,10,19,25]. Thus, it is reasonable to assume that changes of only 10%) would reduce the rate of cartilage wear relative to that of the meniscectomized condition.…”

Section: Discussionmentioning

confidence: 99%

The sensitivity of tibiofemoral contact pressure to the size and shape of the lateral and medial menisci

Donahue

Hull

Rashid

et al. 2004

Journal Orthopaedic Research

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In an effort to prevent degeneration of articular cartilage associated with meniscectomies, both meniscal allografts and synthetic replacements have been studied. A number of biomechanical criteria may be important for a meniscal replacement to restore normal tibiofemoral contact pressure in the knee joint and hence be clinically successful. One of these criteria is geometric similarity. The objectives of the current study were to: determine the sensitivity of the contact variables of the tibial plateau to the transverse depth and width of both the lateral and medial menisci; determine the sensitivity of the contact variables of the tibial plateau to the crosssectional width and height of the lateral and medial menisci; and determine the tolerances on each of the four parameters for both menisci. To satisfy these objectives, a previously developed finite element model of the tibiofemoral joint was used to compute the contact pressure distribution on the tibial plateau. The effect of the above-mentioned geometric parameters on the contact behavior was studied by perturbing the finite element model. Results showed that the contact variables are similarly sensitive to both the transverse and cross-sectional parameters of the menisci. Additionally the medial meniscal parameters have a greater effect on the contact variables than do the lateral meniscal parameters. Finally, less than a 0.5 mm change in the medial meniscal height and greater than a 1 mm change in the lateral meniscal height could be tolerated before the relative difference in the contact variables from those for the original geometry exceeded 10% Thus in the design or selection of meniscal replacements, each of the four parameters should be measured when sizing a replacement tissue. Also tighter tolerances should be placed on the medial meniscal parameters compared to the lateral meniscal parameters.

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Section: Discussionmentioning

confidence: 99%

The sensitivity of tibiofemoral contact pressure to the size and shape of the lateral and medial menisci

Donahue

Hull

Rashid

et al. 2004

Journal Orthopaedic Research

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“…tension, compression, and shear stresses. The main functions are load transmission and shock absorption during dynamic movements (Walker and Erkman 1975, Shrive et al 1978, Seedhom and Hargreaves 1979. The menisci distribute stress over a large area of the articular cartilage.…”

Section: Meniscal Function-load Transmission and Shock Absorptionmentioning

confidence: 99%

“…In the same period of time, several biomechanical studies reported on the load bearing and shock absorbing functions of the menisci (Walker and Erkman 1975, Shrive et al 1978, Seedhom and Hargreaves 1979. It was now time to shift the paradigm to a more restrained attitude to total meniscectomy, 80 years after the introduction of the procedure.…”

Section: Partial Meniscectomymentioning

confidence: 99%

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Meniscal tear - a feature of osteoarthritis

Englund¹

2004

SORT

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Meniscectomy is recognized as an important risk factor for the development of knee osteoarthritis (OA), a disease that traditionally has been considered as a simple "wear and tear" phenomenon. However, despite numerous reports, little evidence has been presented that a limited meniscal resection, compared with a more extensive resection, reduces the risk of OA by preserving meniscal function. Why? This thesis provides one possible answer to that question.Patients, who had undergone isolated meniscal resection in 1973, 1978, or between 1983 and 1985 at Lund University Hospital, Sweden, were reviewed clinically and radiographically 15-22 years after the surgical procedure.Of the subjects (n = 317) almost 50% had developed radiographic OA in their operated knee, but just over half of these patients were symptomatic. An additional 20% of the patients had knee symptoms, but did not have radiographic knee OA. These results confi rm a limited correlation between radiographic features of the disorder and symptoms.A degenerative type of meniscal tear and obesity were the factors most strongly associated with both radiographic knee OA and symptomatic radiographic knee OA.Partial meniscal resection induced less radiographic changes related to knee OA compared with total meniscectomy, but the patient-relevant outcomes remained essentially the same.If radiographic hand OA was present there was an increased likelihood of the patient also having knee OA following meniscectomy. This fi nding was independent of age, and therefore an inherited susceptibility to the disease contributes to the risk of knee OA after meniscal tear. Genetic and environmental risk factors interact in OA development.A degenerative meniscal lesion is often associated with early-stage knee OA, a disorder also involving the meniscal tissue. The tear may thus represent the fi rst "signal" feature of OA. The challenge for the health professional is to discriminate between symptoms caused by a meniscal tear and those caused by OA. Meniscal resection may not benefi t the patient with early-stage knee OA. The intervention merely removes evidence of the disorder, while the OA joint degradation proceeds.

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“…The main functions of the menisci are shock absorption and load transmission in the knee, mainly through distribution of mechanical stress over a large area of the joint cartilage (1)(2)(3)(4). Loss of meniscal function is recognized as a potent risk factor for both the development of knee osteoarthritis (OA) and cartilage loss in OA (5,6).…”

mentioning

confidence: 99%

Effect of meniscal damage on the development of frequent knee pain, aching, or stiffness

Englund¹,

Niu²,

Guermazi³

et al. 2007

Arthritis & Rheumatism

141

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Objective. To evaluate the effect of meniscal damage on the development of frequent knee pain, aching, or stiffness in middle-aged and older adults.Methods. The Multicenter Osteoarthritis Study is a prospective study of 3,026 individuals 50 years of age or older who have or are at high risk of developing knee osteoarthritis (OA). We investigated knees at baseline and at 15 months. Case knees (n ‫؍‬ 110) were those with no pain, aching, or stiffness on most days at baseline, but that had developed frequent pain, aching, or stiffness at 15 months. Control knees (n ‫؍‬ 220) were drawn randomly from knees with no frequent symptoms at baseline that did not become case knees. Using 1.0T magnetic resonance imaging performed at baseline and at followup, 2 musculoskeletal radiologists blinded to the case-control status assessed the meniscal damage using the following scale: 0 ‫؍‬ intact, 1 ‫؍‬ minor tear, 2 ‫؍‬ nondisplaced tear or prior surgical repair, and 3 ‫؍‬ displaced tear, resection, maceration, or destruction. The effect of meniscal damage was analyzed by contingency tables and logistic regression.Results. Meniscal damage was common at baseline both in case knees (38%) and in control knees (29%). Although there was a modest association between the meniscal damage score (range 0-3) and the development of frequent knee pain, aching, or stiffness (odds ratio [OR] 1.21, 95% confidence interval [95% CI] 0.96-1.51, adjusted for age, sex, and body mass index), meniscal damage was mostly present in knees with OA. When considering the co-occurrence of OA, we found no independent association between meniscal damage and the development of frequent knee symptoms (OR 1.05, 95% CI 0.80-1.37).Conclusion. In middle-aged and older adults, any association between meniscal damage and the development of frequent knee pain seems to be present because both pain and meniscal damage are related to OA and not because of a direct link between the two.

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Transmission of the Load in the Knee Joint with Special Reference to the Role of the Menisci

Cited by 148 publications

References 0 publications

The sensitivity of tibiofemoral contact pressure to the size and shape of the lateral and medial menisci

The sensitivity of tibiofemoral contact pressure to the size and shape of the lateral and medial menisci

Meniscal tear - a feature of osteoarthritis

Effect of meniscal damage on the development of frequent knee pain, aching, or stiffness

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