Ohori Tomoki, Mae Tatsuo, Shino Konsei, Tachibana Yuta, Fujie Hiromichi, Yoshikawa Hideki, Nakata Ken
Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Suita, Japan.
Sports Orthopaedic Surgery Center, Yukioka Hospital, Osaka, Japan.
Orthop J Sports Med. 2019 Jan 18;7(1):2325967118821605. doi: 10.1177/2325967118821605. eCollection 2019 Jan.
It has been demonstrated that the load distribution function of the lateral meniscus (LM) is compromised by resecting both the meniscofemoral ligament (MFL) and LM posterior root (LMPR). However, the effect of resecting these fibers on load transmission through the LM needs to be investigated.
To evaluate using a porcine knee model (1) the in situ forces of the MFL and LMPR and (2) the effect of resecting these fibers on the in situ force of the LM under a compressive load and valgus torque to the lateral knee compartment.
Controlled laboratory study.
Twenty fresh-frozen porcine knees and a 6 degrees of freedom robotic system were utilized. An axial compressive load of 250 N and 5 N·m of valgus torque were applied to intact, MFL-deficient, LMPR-deficient, and MFL/LMPR-deficient knees at 30°, 60°, and 90° of flexion. The valgus angles under the applied loads were compared among the 4 states. The in situ forces of the MFL and LMPR under the applied loads were calculated under the principle of superposition. The in situ forces of the LM under the applied loads were also calculated and compared among the 4 conditions (intact, without the MFL, without LMPR, and without the MFL/LMPR).
The valgus angles significantly increased after resecting both the MFL and LMPR at all the flexion angles. The in situ forces of the MFL and LMPR changed reciprocally as the knee flexed. The in situ forces of the LM significantly decreased after resecting both the MFL and LMPR, although resecting only the MFL or LMPR represented no significant effect.
The MFL and LMPR functioned complementarily as the posterior attachments of the LM against a compressive load and valgus torque to the lateral knee compartment in porcine knee joints.
If the LMPR is completely detached and needs to be repaired, the MFL should be preserved because it may provide some stability to the LM posterior horn and protect the repaired LMPR.
已证实，切除半月板股骨韧带（MFL）和外侧半月板后根（LMPR）会损害外侧半月板（LM）的负荷分布功能。然而，切除这些纤维对通过LM的负荷传递的影响仍有待研究。
使用猪膝关节模型评估（1）MFL和LMPR的原位力，以及（2）在向外侧膝关节腔施加压缩负荷和外翻扭矩的情况下，切除这些纤维对LM原位力的影响。
对照实验室研究。
使用20个新鲜冷冻猪膝关节和一个六自由度机器人系统。在膝关节屈曲30°、60°和90°时，对完整、MFL缺陷、LMPR缺陷和MFL/LMPR缺陷的膝关节施加250 N的轴向压缩负荷和5 N·m的外翻扭矩。比较4种状态下施加负荷时的外翻角度。根据叠加原理计算施加负荷时MFL和LMPR的原位力。还计算了施加负荷时LM的原位力，并在4种情况（完整、无MFL、无LMPR、无MFL/LMPR）之间进行比较。
在所有屈曲角度下，切除MFL和LMPR后，外翻角度均显著增加。MFL和LMPR的原位力随膝关节屈曲而呈反向变化。切除MFL和LMPR后，LM的原位力显著降低，尽管仅切除MFL或LMPR并无显著影响。
在猪膝关节中，MFL和LMPR作为LM的后附着结构，在抵抗外侧膝关节腔的压缩负荷和外翻扭矩方面发挥互补作用。
如果LMPR完全分离且需要修复，应保留MFL，因为它可能为LM后角提供一定稳定性并保护修复后的LMPR。
