Baratz M E, Fu F H, Mengato R
Am J Sports Med. 1986 Jul-Aug;14(4):270-5. doi: 10.1177/036354658601400405.
The role of the meniscus in load transmission across the knee has long been a subject of debate. In this study, we examined the biomechanical consequences of the operative treatments for bucket-handle and peripheral meniscal tears. Contact areas and instantaneous intraarticular pressure distributions were measured in two groups of human cadaver knees. In Group I, consisting of four knees, we created a bucket-handle tear involving the inner one-third of the meniscus, followed by partial, and then total meniscectomy. Knees were tested in an Instron testing machine after each procedure, using a 400 pound load at 0 degrees or 30 degrees flexion. Contact areas and local stresses were measured using Prescale, a pressure-sensitive film. After partial meniscectomy, contact areas decreased approximately 10%, and peak local contact stresses (PLCS) increased approximately 65%. After total meniscectomy, contact areas decreased approximately 75%, and PLCS increased approximately 235%. In Group II, consisting of three additional knees, we created a 2 cm peripheral tear of the posterior meniscal horn, followed by open repair, arthroscopic repair, segmental, and then total meniscectomy. Repair of the tear was accomplished with either vertically placed sutures by an open technique or horizontally placed sutures by an arthroscopic technique. Knees were tested in the neutral position in the Instron machine and contact areas and local stresses measured using Prescale. PLCSs and contact areas were found to be the same using either repair technique. There was, however, a 110% increase in PLCS after segmental meniscectomy of that portion of the meniscus involved in the peripheral tear.(ABSTRACT TRUNCATED AT 250 WORDS)
半月板在膝关节负荷传递中的作用长期以来一直是个争论的话题。在本研究中，我们检查了桶柄状和半月板周边撕裂手术治疗的生物力学后果。在两组人体尸体膝关节中测量了接触面积和关节内瞬时压力分布。在第一组中，由四个膝关节组成，我们制造了一个累及半月板内三分之一的桶柄状撕裂，随后进行部分半月板切除术，然后是全半月板切除术。在每个手术步骤后，使用Instron测试机对膝关节进行测试，在0度或30度屈曲时施加400磅的负荷。使用Prescale（一种压敏膜）测量接触面积和局部应力。部分半月板切除术后，接触面积减少约10%，局部接触应力峰值（PLCS）增加约65%。全半月板切除术后，接触面积减少约75%，PLCS增加约235%。在第二组中，由另外三个膝关节组成，我们制造了一个后半月板角2厘米的周边撕裂，随后进行开放修复、关节镜修复、部分半月板切除术，然后是全半月板切除术。撕裂的修复通过开放技术垂直放置缝线或关节镜技术水平放置缝线来完成。在Instron机器中于中立位对膝关节进行测试，并使用Prescale测量接触面积和局部应力。发现两种修复技术的PLCS和接触面积相同。然而，在对涉及周边撕裂的半月板部分进行部分半月板切除术后，PLCS增加了110%。（摘要截断于250字）
