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Partial meniscectomy does not affect the biomechanics of anterior cruciate ligament reconstructed knee with a lateral posterior meniscal root tear

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

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.

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Acknowledgements

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Funding

Department of Orthopedic Surgery, University of Pittsburgh.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu, China

    Xin Tang & Jian Li

  2. Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, Suite 1011, Pittsburgh, PA, 15213, USA

    Xin Tang, Joon Ho Wang, Monica A. Linde, Patrick Smolinski & Freddie H. Fu

  3. Department of Mechanical Engineering and Material Science Engineering, University of Pittsburgh, Pittsburgh, PA, USA

    Brandon Marshall, Junjun Zhu, Patrick Smolinski & Freddie H. Fu

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  1. Xin Tang
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  3. Joon Ho Wang
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All authors contributed to the preparation of this work.

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Correspondence to Freddie H. Fu.

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Prior approval was obtained at the University of Pittsburgh for this human cadaver study from the Committee for Oversight of Research and Clinical Training Involving Decedents.

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Tang, X., Marshall, B., Wang, J.H. et al. Partial meniscectomy does not affect the biomechanics of anterior cruciate ligament reconstructed knee with a lateral posterior meniscal root tear. Knee Surg Sports Traumatol Arthrosc 28, 3481–3487 (2020). https://doi.org/10.1007/s00167-020-06209-9

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