Rush University Medical Center, 720 North Larrabee Street, #1010, Chicago, IL 60654, USA.
Am J Sports Med. 2012 Aug;40(8):1863-70. doi: 10.1177/0363546512453291. Epub 2012 Jul 11.
Radial transection of the peripheral fibers of the meniscus could render it nonfunctional; however, the biomechanical consequences of a complete lateral meniscal radial tear and repair in human specimens have not been elucidated.
A complete radial tear will exhibit knee contact mechanics approaching those of total meniscectomy. Repair of complete radial tears will re-create normal load transmission across the joint.
Controlled laboratory study.
Five matched pairs of fresh-frozen human cadaveric knees were tested in axial compression (800 N) at 2 knee flexion angles (0° and 60°). Six meniscal conditions were sequentially tested: (1) intact lateral meniscus; radial width tears of (2) 50%, (3) 75%, and (4) 100%; (5) meniscal repair; and (6) total meniscectomy. Repairs were pair matched and used either an inside-out or all-inside technique. Tekscan sensors measured tibiofemoral contact pressure, peak contact force, and contact area in the lateral meniscus and medial meniscus.
Complete radial tears of the lateral meniscus produced significant increases in mean contact pressure (P = .0001) and decreased contact area (P < .0001) compared with the intact state. This effect was significantly less than that of total meniscectomy (P < .0023). Lesser degrees of radial tears were not significantly different from the intact state (P > .3619). Mean contact pressure after either repair technique was not significantly different from the intact state (P = .2595) or from each other (P = .4000). Meniscal repair produced an increase in contact area compared with a complete tear but was still significantly less than that of the intact meniscus (P < .0001). The medial compartment showed no significant difference between all testing conditions for 0° and 60° of flexion (P ≥ .0650).
A complete radial meniscal tear of the lateral meniscus has a detrimental effect on load transmission. Repair improved contact area and pressure. Contact pressures for repaired menisci were not significantly different from the intact state, but contact area was significantly different. Biomechanical performance of repair constructs was equivalent.
Repair of complete radial tears improves joint mechanics, potentially decreasing the likelihood of cartilage degeneration.
半月板外周纤维的横断会使其失去功能；然而，在人体标本中，完全的外侧半月板放射状撕裂和修复的生物力学后果尚未阐明。
完全的放射状撕裂会表现出接近全半月板切除术的膝关节接触力学。完全的放射状撕裂修复将重新在关节中创建正常的负载传递。
对照实验室研究。
在 2 个膝关节弯曲角度（0°和 60°）下，对 5 对匹配的新鲜冷冻人体尸体膝关节进行轴向压缩（800N）测试。依次测试了 6 种半月板条件：（1）完整的外侧半月板；（2）50%、（3）75%和（4）100%的放射状宽度撕裂；（5）半月板修复；和（6）全半月板切除术。修复是配对匹配的，并使用内部或全部内部技术。Tekscan 传感器测量外侧和内侧半月板的胫股接触压力、峰值接触力和接触面积。
与完整状态相比，外侧半月板的完全放射状撕裂会导致平均接触压力显著增加（P =.0001）和接触面积减小（P <.0001）。这种影响明显小于全半月板切除术（P <.0023）。较小程度的放射状撕裂与完整状态无显著差异（P >.3619）。无论使用哪种修复技术，平均接触压力均与完整状态（P =.2595）或彼此之间（P =.4000）无显著差异。与完全撕裂相比，半月板修复增加了接触面积，但仍明显小于完整半月板（P <.0001）。内侧关节间隙在 0°和 60°的所有测试条件下均无显著差异（P ≥.0650）。
外侧半月板的完全放射状撕裂对负载传递有不利影响。修复改善了接触面积和压力。修复后的半月板的接触压力与完整状态无显著差异，但接触面积有显著差异。修复结构的生物力学性能相当。
完全放射状撕裂的修复可改善关节力学，可能降低软骨退化的可能性。
