Pena E, Calvo B, Martinez M, Palanca D,
Doblare M. Clinical Biomechanics, 2005; 20, 498 – 507.
Previous post focused on the relationship
between knee joint position sense and meniscal transplantation. There is a
suggestion in the literature that knee proprioception is affected by
meniscectomy or meniscal tears and meniscus transplantation seems to restore knee
proprioceptive sensibility. This post is going to describe and analyze effect
of meniscectomy and meniscal tear on knee joint biomechanics.
Authors created
3D finite element model of the human knee joint after meniscal tear and partial
meniscectomy to assess contact areas and pressure distribution between menisci
and articular cartilage which could help to understand mechanisms of early
cartilage degeneration following knee total or partial meniscectomy. Vertical
compression force of 1150 N was applied to the knee joint in three conditions:
healthy, meniscal tear, meniscectomy. Only static analyses were undertaken.
In meniscal tear situation, study found
that contact pressures and compression stresses increased by 50% to 150%
depending on the structure and lesion type (meniscal tear, healthy meniscus,
tibial/femoral cartilage; longitudinal, radial, oblique). Higher values were
seen in totally meniscectomised joint, especially regarding articular cartilage
(even up to 300% increase in compression stress). Authors noted appearance of
new high contact stress in areas where it does not take place in healthy joint.
They state that it may provoke instability and definitely alters knee
kinematics. Similar knee behavior has been severally reported in case of ACL
tear and following ACL reconstruction where articular cartilage was stressed in
regions where is does not usually happens in a healthy joint. Moreover, longitudinal
tear, where the amount of resectionized material is biggest, resulted in
redistribution of the contact zones and stresses while opposite was seen in
radial and oblique tears. In that case, contact pressure and compression stress
significantly increased directly at lesion site.
Despite several limitations including
possible error associated with this kind of measurement method, lack of
comparison between different knee ranges of motion and lack of more accurate
meniscus and cartilage models, this study proves the importance of such terms
as preservation and meniscal repair for healthy knee joint biomechanics and for
early OA prevention.
All rights reserved to the Clinical Biomechanics.
All rights reserved to the Clinical Biomechanics.
Nice post. Meniscal tear is the most common knee injury. Thanks for sharing.
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