Steineman Brett D, LaPrade Robert F, Santangelo Kelly S, Warner Brent T, Goodrich Laurie R, Haut Donahue Tammy L
School of Biomedical Engineering, Colorado State University, Fort Collins, Colorado, USA.
The Steadman Clinic, Vail, Colorado, USA.
Orthop J Sports Med. 2017 Apr 27;5(4):2325967117702452. doi: 10.1177/2325967117702452. eCollection 2017 Apr.
Meniscal root tears cause menisci and their insertions to inadequately distribute loads and potentially leave underlying articular cartilage unprotected. Untreated meniscal root tears are becoming increasingly recognized to induce joint degradation; however, little information is known about anterior meniscal root tears and how they affect joint tissue.
To observe the early degenerative changes within the synovial fluid, menisci, tibial articular cartilage, and subchondral bone after arthroscopic creation of untreated anterior meniscal root tears.
Controlled laboratory study.
Anterolateral meniscal root tears were created in 1 knee joint of 5 adult Flemish Giant rabbits, and anteromedial meniscal root tears were created in 4 additional rabbits. The contralateral limbs were used as nonoperated controls. The animals were euthanized at 8 weeks postoperatively; synovial fluid was aspirated, and tissue samples of menisci and tibial articular cartilage were collected and processed for multiple analyses to detect signs of early degeneration.
Significant changes were found within the synovial fluid, meniscal tissue, and tibial subchondral bone of the knees with anterior meniscal root tears when compared with controls. There were no significant changes identified in the tibial articular cartilage when comparing the tear groups with controls.
This study demonstrated early degenerative changes within the synovial fluid, menisci, and tibial subchondral bone when leaving anterior meniscal root tears untreated for 8 weeks. The results suggest that meniscal tissue presents measurable, degenerative changes prior to changes within the articular cartilage after anterior meniscal root tears. Anterior destabilization of the meniscus arthroscopically may lead to measurable degenerative changes and be useful for future in vivo natural history and animal repair studies.
The present study is the first to investigate various tissue changes after anterior meniscal root tears of both the medial and lateral menisci. The results from this study suggest that degenerative changes occur within the synovial fluid, meniscus, and tibial subchondral bone prior to any measurable changes to the tibial articular cartilage. Further studies should expand on this study to evaluate how these components continue to progress when left untreated for long periods.
半月板根部撕裂会导致半月板及其附着处无法充分分散负荷,并可能使下方的关节软骨得不到保护。未经治疗的半月板根部撕裂越来越被认为会导致关节退变;然而,关于前半月板根部撕裂及其对关节组织的影响,人们了解的信息很少。
观察在关节镜下制造未经治疗的前半月板根部撕裂后,滑液、半月板、胫骨关节软骨和软骨下骨内的早期退变变化。
对照实验室研究。
在5只成年弗拉芒巨兔的1个膝关节中制造前外侧半月板根部撕裂,在另外4只兔子中制造前内侧半月板根部撕裂。对侧肢体用作未手术对照。动物在术后8周实施安乐死;抽取滑液,并收集半月板和胫骨关节软骨的组织样本,进行多项分析以检测早期退变迹象。
与对照组相比,在前半月板根部撕裂的膝关节的滑液、半月板组织和胫骨软骨下骨内发现了显著变化。将撕裂组与对照组比较时,胫骨关节软骨未发现显著变化。
本研究表明,未经治疗8周的前半月板根部撕裂会导致滑液、半月板和胫骨软骨下骨出现早期退变变化。结果表明,前半月板根部撕裂后,半月板组织在关节软骨出现变化之前就呈现出可测量的退变变化。关节镜下半月板前侧失稳可能会导致可测量的退变变化,对未来的体内自然史和动物修复研究有用。
本研究首次调查了内侧和外侧半月板前半月板根部撕裂后各种组织的变化。本研究结果表明,在胫骨关节软骨出现任何可测量的变化之前,滑液、半月板和胫骨软骨下骨内就会发生退变变化。进一步的研究应在本研究基础上展开,以评估这些成分在长期未治疗时如何继续发展。