Biomedical Engineering, University of Delaware, Newark, DE 19716.
Department of Orthopaedic Surgery, Penn Medicine, University of Pennsylvania, Philadelphia, PA 19104.
J Biomech Eng. 2023 Aug 1;145(8). doi: 10.1115/1.4062524.
The meniscus serves important load-bearing functions and protects the underlying articular cartilage. Unfortunately, meniscus tears are common and impair the ability of the meniscus to distribute loads, increasing the risk of developing osteoarthritis. Therefore, surgical repair of the meniscus is a frequently performed procedure; however, repair does not always prevent osteoarthritis. This is hypothesized to be due to altered joint loading post-injury and repair, where the functional deficit of the meniscus prevents it from performing its role of distributing forces. The objective of this study was to quantify joint kinematics in an intact joint, after a meniscus root tear, and after suture repair in cadaveric porcine knees, a frequently used in vivo model. We utilized an magnetic resonance images-compatible loading device and novel use of a T1 vibe sequence to measure meniscus and femur displacements under physiological axial loads. We found that anterior root tear led to large meniscus displacements under physiological axial loading and that suture anchor repair reduced these displacements but did not fully restore intact joint kinematics. After tear and repair, the anterior region of the meniscus moved posteriorly and medially as it was forced out of the joint space under loading, while the posterior region had small displacements as the posterior attachment acted as a hinge about which the meniscus pivoted in the axial plane. Methods from this study can be applied to assess altered joint kinematics following human knee injuries and evaluate repair strategies aimed to restore joint kinematics.
半月板起着重要的承重功能，并保护下方的关节软骨。不幸的是，半月板撕裂很常见，会降低半月板分配负荷的能力，增加发展为骨关节炎的风险。因此，半月板的手术修复是一种经常进行的手术；然而，修复并不总是能预防骨关节炎。这被假设是由于受伤和修复后的关节负荷改变，半月板的功能缺陷使其无法发挥其分配力量的作用。本研究的目的是在猪尸体膝关节中定量测量完整关节、半月板根撕裂后和半月板缝合修复后的关节运动学，这是一种常用的体内模型。我们使用了一种与磁共振成像兼容的加载装置和 T1 vibe 序列的新用途来测量在生理轴向负荷下半月板和股骨的位移。我们发现，前根撕裂会导致半月板在生理轴向负荷下产生较大的位移，而缝合锚修复虽然减少了这些位移，但并未完全恢复完整关节的运动学。在撕裂和修复后，半月板的前区域在加载下被迫离开关节间隙时向后和向内侧移动，而后区域的位移较小，因为后附着作为铰链，半月板在轴向平面上围绕其枢转。本研究中的方法可用于评估人类膝关节损伤后的关节运动学改变，并评估旨在恢复关节运动学的修复策略。
