Purpose

The purpose of this study was to determine the effects of a lateral meniscus posterior root tear, partial meniscectomy, and total meniscectomy on knee biomechanics in the setting of anterior cruciate ligament (ACL) reconstruction.

Methods

Thirteen fresh-frozen cadaver knees were tested with a robotic testing system under an 89.0-N anterior tibial load at full extension (FE), 15°, 30°, 60° and 90° of knee flexion and a simulated pivot-shift loading (7.0 Nm valgus and 5.0 Nm internal tibial rotation) at FE, 15° and 30° of knee flexion. Anterior tibial translation (ATT) and the in-situ force of ACL graft under the different loadings were measured in four knee states: (1) ACL reconstruction with intact lateral meniscus (Intact meniscus), (2) ACL reconstruction with lateral meniscal posterior root tear (Root tear), (3) ACL reconstruction with lateral posterior partial meniscectomy (Partial meniscectomy) and (4) ACL reconstruction with total lateral meniscectomy (Total meniscectomy).

Results

Under anterior tibial loading, compared with an intact meniscus, root tear significantly increased ATT at 15° and 30° of knee flexion (p < 0.05) and partial meniscectomy had almost same increased ATT as with root tear at any knee flexion between FE and 90°. Under simulated pivot-shift loading, total meniscectomy increased ATT compared with intact meniscus, root tear, partial meniscectomy at FE (p < 0.05).

Conclusion

Under anterior tibial and simulated pivot-shift loading, partial meniscectomy has no significant effect on the stability of ACL-reconstructed knee with lateral meniscal posterior root tear, while total meniscectomy increased laxity at less than 30° of knee flexion. Clinically, in cases of irreparable meniscal root tears or persistent pain a partial meniscectomy can be considered in the setting of ACL reconstruction.

中文翻译：

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半月板切除术不影响前交叉韧带重建膝关节并具有后半月板外侧根撕裂的膝关节的生物力学。

目的

这项研究的目的是确定在前交叉韧带（ACL）重建的情况下外侧半月板后根撕裂，部分半月板切除和全半月板切除对膝关节生物力学的影响。

方法

使用机器人测试系统对13个新鲜冷冻的尸体膝盖进行了测试，分别在89.0-N胫骨前载荷下进行了全伸展（FE），膝关节屈曲15°，30°，60°和90°以及模拟的枢转移位载荷（在FE，膝盖屈曲15°和30°时，外翻7.0 Nm，胫骨内旋转5.0 Nm。在四个膝关节状态下测量了胫骨前平移（ATT）和不同负荷下ACL移植物的原位力：（1）完整半月板的ACL重建（完整半月板），（2）侧面半月板后根的ACL重建撕裂（根撕裂），（3）外侧后半月板切除术（部分半月板切除术）ACL重建，（4）全侧面半月板切除术（总半月板切除术）ACL重建。

结果

在胫骨前部负荷下，与完整的半月板相比，膝关节屈曲在15°和30°时，根部撕裂显着增加了ATT（p  <0.05），半月板切除术在FE至90之间的任何膝部屈曲中，ATT的增加几乎与根部撕裂相同°。在模拟枢轴移位负荷下，与半月板完整，根部撕裂，半月板半月板切除术相比，半月板全切术增加了ATT（p  <0.05）。

结论

在胫骨前部和模拟枢轴移位负荷下，半月板切除对ACL重建的膝关节伴侧半月板后根撕裂的稳定性没有明显影响，而全半月板切除术在屈膝度小于30°时增加了松弛度。在临床上，如果发生不可修复的半月板根部撕裂或持续疼痛，可以在ACL重建中考虑部分半月板切除术。