Thijs Y, Witrouv E, Evens B, Coorevits P,
Almqwist F, Verdonk R. Scandynavian Journal of Medicine&Science in Sport,
2007; 17, 223 – 229.
Knee menisci act to disperse the weight of
the body and to reduce friction between femur and tibia during movement. It
also functions as a knee joint stabilizer, mechanical and proprioceptive since
three types of mechanoreceptors have been identified in both of menisci horns
at the beginning of 90’. Previous research has shown proprioception
deterioration in meniscectomised knee as well as in the knee with torn
meniscus. Lack of papers had existed on knee joint proprioceptive ability after
meniscal transplantation therefore authors prospectively assessed knee joint
position sense before and after meniscus replacement.
Fourteen patients had their knee joint position
sense tested with Biodex System III Isokinetic Dynamometer preoperatively and
at six months follow – up. Additionally, knee disability in daily activities,
was assessed with WOMAC scale prior and post-surgery. WOMAC scale did not find
any statistically significant differences regarding pain, joint stiffness or
physical function. In general, that was in contrast to previous research. Authors
believe that follow – up period of six months could be too short to detect any significant
effect. Active and passive knee joint position sense significantly improved
after meniscus transplantation. According to authors, it might be
hypothetically explained with increased number of mechanoreceptors provided
with the transplant which resulted in better proprioceptive input. On the other
hand, enhanced joint position sense might be due to improvement of knee
kinematics and normalization of the tension on the capsular structures
effecting after meniscal replacement. Moreover, postoperative rehabilitation could
also be the factor contributing to knee joint position sense improvement by stimulating
periarticular mechanoreceptors in the capsule, tendons and muscles.
Lack of control group, small sample size
and short term follow – up limits the study to some degree. Nevertheless,
results prove the importance of the menisci for knee stability and functionality;
therefore it seems reasonable for othopaedic surgeons, not to perform
meniscectomy if it is not really required. Research with longer follow – ups (1 – 8 years)
show improvement in knee function following meniscus transplantation. Meniscus transplantation does not resolve the
problem itself, we need to remember about appropriate postoperative treatment,
tissue healing process and concomitant lesions. There is a need to conduct further studies on
knee proprioception following meniscal replacement and how it will influence
joint functionality in longer – term.
All rights reserved to the Scandynavian Journal of Medicine&Science in Sport.
All rights reserved to the Scandynavian Journal of Medicine&Science in Sport.
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