Dürselen, L., Vögele, S., Seitz, A., Ignatius, A., Friederich, N., Bauer, G. and Majewski, M. American Journal of Sports Medicine, 2011; 39: 1749-1755.
http://www.ncbi.nlm.nih.gov/pubmed/21550989
Meniscal lesions are commonly associated
with ACL tears. Lack of appropriate surgical and/or conservative treatment
after ACL rupture, may lead to meniscal tears, especially in chronic
conditions. Despite this, there is some evidence that ACL-deficient knees might
be dynamically stable. However, inconsistency exists in which kind of knee
motion or knee loading may place increased stress and loading on the meniscus/meniscal
repair site. The main purpose of this study was to test the effect of different
knee joint motion and loading conditions on the gapping behavior of
longitudinal posterior horn meniscal tears in stable and ACL-deficient knee
joints.
Longitudinal tears of 3 cm were surgically made in the posterior horn of the medial menisci in 10 human cadaveric knee joints. The maximum gap width occurring during various knee motions and loading patters was monitored in intact and ACL-deficient joints before and after meniscal repair. The axial joint load was 30 N or 200 N alternatively.
Longitudinal tears of 3 cm were surgically made in the posterior horn of the medial menisci in 10 human cadaveric knee joints. The maximum gap width occurring during various knee motions and loading patters was monitored in intact and ACL-deficient joints before and after meniscal repair. The axial joint load was 30 N or 200 N alternatively.
Results showed that longitudinal meniscal
tears gapped significantly wider after ACL transection under 30-N axial joint
load except two conditions: the combination of a valgus and an external tibial
rotation moment at 30-N axial load and a solitary external tibial rotation
moment at 200-N axial joint load. After repair of the meniscal lesions, the tears
gapped significantly less compared with the unrepaired condition. However, transecting
the ACL also increased the gap width for the repaired menisci.
In conclusion, results suggest that ACL insufficiency leads to increased meniscal load that may broaden already existing gap in the meniscus. Moreover, this was also the case after the meniscal repair. It seems that findings of the study may prove that in ACL – deficient knees, menisci might be placed into higher stress which in result may lead to further damage of the cartilage. Neverthless, authors did not find single knee motion or knee loading situation that actually altered meniscal loading compared with the other motion and loading conditions tested.
All rights reserved to the American Journal of Sports Medicine.
In conclusion, results suggest that ACL insufficiency leads to increased meniscal load that may broaden already existing gap in the meniscus. Moreover, this was also the case after the meniscal repair. It seems that findings of the study may prove that in ACL – deficient knees, menisci might be placed into higher stress which in result may lead to further damage of the cartilage. Neverthless, authors did not find single knee motion or knee loading situation that actually altered meniscal loading compared with the other motion and loading conditions tested.
All rights reserved to the American Journal of Sports Medicine.
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