Department of Sports Orthopaedic Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Department of Orthopaedics and Sportsorthopaedics, Technical, University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
Knee Surg Sports Traumatol Arthrosc. 2018 Aug;26(8):2302-2309. doi: 10.1007/s00167-018-4949-8. Epub 2018 Apr 27.
To investigate the stabilizing effect of a lateral meniscus posterior root repair in an ACL and root deficient knee.
The hypothesis of the current study was that a sequential transection of the posterior root and the meniscofemoral ligaments in an ACL-deficient knee increases rotational instability, and conversely, a repair of the meniscus root reduces the internal tibial rotation. Therefore, eight human knee joints were tested in a robotic setup (5 N m internal torque, 50 N m anterior translation load). Five conditions were tested: intact, ACL cut, ACL cut + lateral meniscus posterior root tear (LMRT), ACL cut + LMRT + transection of the MFL and ACL cut + lateral meniscus root repair. The angles of internal tibial rotation as well as anterior tibial translation were recorded.
Transection of the lateral meniscus posterior root increased the internal tibial instability as compared to the ACL-insufficient state. A significant increase was detected in 60° and 90° of flextion. Sectioning of the meniscofemoral ligament further destabilized the knees significantly at all flexion angles as compared to the ACL-deficient state. Even in 30°, 60° and 90° a significant difference was detected as compared to the isolated root tear. A tibial fixation of the lateral meniscus root reduced the internal tibial rotation in all flexion angles and led to a significant decrease of internal tibial rotation in 30° and 90° as compared to the transection of the root and the MFL. The anterior tibial translation was increased in all conditions as compared to the native state.
A lateral meniscus root repair can reduce internal tibial rotation in the ACL-deficient knee. To check the condition of the lateral posterior meniscus root attachment is clinical relevant as a lateral meniscus root repair might improve rotational stability.
研究 ACL 和根骨缺失膝关节中半月板后根修复的稳定效果。
本研究的假设是，ACL 缺陷膝关节中后根和半月板股骨韧带的连续切断会增加旋转不稳定性，相反，半月板根修复会减少胫骨内旋。因此，在机器人设置中测试了 8 个人膝关节（5 Nm 内部扭矩，50 Nm 前向平移负载）。测试了 5 种情况：完整、ACL 切断、ACL 切断+外侧半月板后根撕裂（LMRT）、ACL 切断+LMRT+外侧半月板股骨韧带切断和 ACL 切断+外侧半月板根修复。记录了胫骨内旋角度和前胫骨平移。
与 ACL 不足状态相比，外侧半月板后根切断增加了胫骨内稳定性。在 60°和 90°的屈曲时，明显增加。与 ACL 缺陷状态相比，切断半月板股骨韧带进一步显著增加了所有屈曲角度的膝关节不稳定性。即使在 30°、60°和 90°时，与孤立的根部撕裂相比，也检测到了显著差异。外侧半月板根部的胫骨固定减少了所有屈曲角度的胫骨内旋转，并导致与根部和 MFL 切断相比，在 30°和 90°时胫骨内旋转显著减少。与原生状态相比，所有条件下的前胫骨平移均增加。
ACL 缺陷膝关节中半月板后根修复可减少胫骨内旋转。检查外侧后半月板根部附着的情况具有临床相关性，因为外侧半月板根部修复可能会改善旋转稳定性。
