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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Bedi, Asheesh Kelly, Natalie H. Baad, Michael Fox, Alice J. S. Brophy, Robert H. Warren, Russell F. Maher, Suzanne A. |
| Description | Country affiliation: United States Author Affiliation: Bedi A ( Sports Medicine and Shoulder Service, The Hospital for Special Surgery, New York, NY 10021, USA.) |
| Abstract | BACKGROUND: The menisci are integral to normal knee function. The purpose of this study was to measure the contact pressures transmitted to the medial tibial plateau under physiological loads as a function of the percentage of the meniscus involved by the radial tear or repair. Our hypotheses were that (1) there is a threshold size of radial tears above which contact mechanics are adversely affected, and (2) partial meniscectomy results in increased contact pressure compared with that found after meniscal repair. METHODS: A knee simulator was used to apply physiological multidirectional dynamic gait loads across human cadaver knees. A sensor inserted below the medial meniscus recorded contact pressures in association with (1) an intact meniscus, (2) a radial tear involving 30% of the meniscal rim width, (3) a radial tear involving 60% of the width, (4) a radial tear involving 90% of the width, (5) an inside-out repair with horizontal mattress sutures, and (6) a partial meniscectomy. The effects of these different types of meniscal manipulation on the magnitude and location of the peak contact pressure were assessed at 14% and 45% of the gait cycle. RESULTS: The peak tibial contact pressure in the intact knees was 6 +/- 0.5 MPa and 7.4 +/- 0.6 MPa at 14% and 45% of the gait cycle, respectively. The magnitude and location of the peak contact pressure were not affected by radial tears involving up to 60% of the meniscal rim width. Radial tears involving 90% resulted in a posterocentral shift in peak-pressure location manifested by an increase in pressure in that quadrant of 1.3 +/- 0.5 MPa at 14% of the gait cycle relative to the intact condition. Inside-out mattress suture repair of a 90% tear did not restore the location of the pressure peak to that of the intact knee. Partial meniscectomy led to a further increase in contact pressure in the posterocentral quadrant of 1.4 +/- 0.7 MPa at 14% of the gait cycle. CONCLUSIONS: Large radial tears of the medial meniscus are not functionally equivalent to meniscectomies; the residual meniscus continues to provide some load transmission and distribution functions across the joint. |
| File Format | HTM / HTML |
| ISSN | 00219355 |
| Issue Number | 6 |
| Volume Number | 92 |
| e-ISSN | 15351386 |
| Journal | The Journal of Bone and Joint Surgery-American Volume |
| Language | English |
| Publisher | Lippincott Williams & Wilkins |
| Publisher Date | 2010-06-01 |
| Publisher Place | United States |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Orthopedic surgery Knee Injuries Physiopathology Knee Joint Menisci, Tibial Aged Biomechanical Phenomena Cadaver Female Humans Surgery Physiology Middle Aged Journal Article Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Surgery Sports Science |
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