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Influence of a posteromedial meniscocapsular injury on the knee anterior laxity. A cadaveric study

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The number of anterior cruciate ligament (ACL) injuries has considerably increased in the recent years, especially in young adults and adolescents. Associated meniscal tears increase anterior and rotary laxity. Posterior peripheral meniscocapsular tear of medial meniscus is also called ramp lesion. Prevalence of 9% to 17% in adults and up to 23% in pediatric population has been reported. The aim of this study was to determine anterior laxity of cadaveric ACL-deficient knees with several size of ramp lesions.

Methods

Fresh cadaveric knees were explored. Major osteoarthritis and/or ACL and meniscal tears on arthroscopy were exclusion criteria. Mean age at death was 86 years old. Dynamic laximetry with GNRB® device was made in several conditions: Knee prior to any procedure, after arthroscopic exploration, after ACL section, and then after increasing sizes of ramp lesions up to 30 mm. Anteroposterior laxity was measured with 2 loading forces successively (134N and 200N).

Results

After ACL section only, tibiofemoral joint anterior laxity was significantly increased. Mean increase was 156% regardless of the loading force. No statistical laxity difference was found between knees with ACL section only and knees with ACL and meniscal section for any size of ramp lesions. Increasing size of ramp lesion was not correlated with increasing of laxity.

Conclusion

We could not find a threshold size of ramp lesion which increases knee anterior laxity. We were not able to determine a threshold recommending a ramp lesion repair.

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Funding

No funds, grants, or other support were received.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Children’s Hospital, CHU de Toulouse, 31000, Toulouse, France

    Isabelle Bernardini, Daniel N’dele, Jérôme Sales de Gauzy & Franck Accadbled

  2. Institut de Mécanique Des Fluides de Toulouse, IMFT, CNRS, Université de Toulouse, 31000, Toulouse, France

    Jérôme Sales de Gauzy & Franck Accadbled

  3. Anatomy Laboratory, Paul Sabatier University, 31000, Toulouse, France

    Franck Accadbled

  4. Sport Pro Santé Research, 8 Rue Des Braves, 31300, Toulouse, France

    Franck Accadbled

  5. Orthopédie Traumatologie, Hôpital Des Enfants, 330 Avenue de Grande Bretagne, TSA 70034, 31059, Toulouse Cedex 9, France

    Franck Accadbled

Authors
  1. Isabelle Bernardini
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  2. Daniel N’dele
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  3. Jérôme Sales de Gauzy
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  4. Franck Accadbled
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Isabelle Bernardini, Daniel N’dele, and Franck Accadbled. The first draft of the manuscript was written by Isabelle Bernardini, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Franck Accadbled.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The experiments comply with the current laws of the country in which they were performed.

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Bernardini, I., N’dele, D., de Gauzy, J.S. et al. Influence of a posteromedial meniscocapsular injury on the knee anterior laxity. A cadaveric study. Eur J Orthop Surg Traumatol 34, 517–522 (2024). https://doi.org/10.1007/s00590-023-03688-7

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  • DOI: https://doi.org/10.1007/s00590-023-03688-7

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