Meadows Kyle D, Peloquin John M, Boyes Madeline, Stoeckl Brendan D, Benson Jamie, Bansal Sonia, Steinberg David R, Zgonis Miltiadis H, Schaer Thomas P, Mauck Robert L, Elliott Dawn M
Biomedical Engineering, University of Delaware, Newark, Delaware, USA.
Department of Clinical Studies New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
J Orthop Res. 2025 Mar;43(3):692-702. doi: 10.1002/jor.26022. Epub 2024 Nov 25.
This study investigated joint kinematics and attachment tensile mechanics following resection of the medial meniscus anterior attachment. A secondary objective investigated the repair of the attachment. Yucatan minipigs underwent unilateral surgery for either Injury (en bloc) resection of the anterior attachment of the insertional ligament, (a portion of the cranial medial meniscotibial ligament) or Repair (immediate repair with a suture anchor), with the contralateral knee as Intact control. Evaluation at 6 weeks and 6 months included joint kinematics measured from MRI acquired under knee compression and tensile testing of the attachment. Injury resulted in large levels of meniscus extrusion, despite the development of a fibrovascular scar. At 6 weeks, the meniscus extruded 1.95 mm more than Intact; at 6 months, this extrusion was reduced to 0.77 mm. Under an applied 1× body weight load, the meniscus further extruded and was not different with treatment or time. During attachment tensile testing, elongation was 0.6 mm for Intact, following Injury, elongation was 2.7 mm at 6 weeks and was partially restored to 1.5 mm at 6 months. Despite this, the cartilage wear worsened over time. Repair was inadequate to avoid the extrusion or cartilage wear seen in the injury group at 6 weeks, so it was not continued for the 6-month group. This study demonstrates that while meniscus injury is useful to study cartilage degeneration, a holistic consideration of the role of the meniscus itself, including its changing material properties and its impact on joint mechanics during injury, repair, and rehabilitation, are key factors contributing to overall joint health.
本研究调查了内侧半月板前附着部切除后的关节运动学和附着部拉伸力学。第二个目标是研究附着部的修复情况。尤卡坦小型猪接受单侧手术，手术方式为损伤（整块）切除插入韧带的前附着部（颅内侧半月板胫骨韧带的一部分）或修复（用缝合锚钉立即修复），对侧膝关节作为完整对照。在6周和6个月时进行评估，包括在膝关节受压情况下通过MRI测量关节运动学以及对附着部进行拉伸试验。尽管形成了纤维血管瘢痕，但损伤导致大量半月板挤出。在6周时，半月板挤出量比完整组多1.95毫米；在6个月时，这种挤出量减少到0.77毫米。在施加1倍体重负荷时，半月板进一步挤出，且在治疗或时间方面无差异。在附着部拉伸试验中，完整组的伸长量为0.6毫米，损伤组在6周时伸长量为2.7毫米，在6个月时部分恢复到1.5毫米。尽管如此，软骨磨损随时间加剧。修复不足以避免在6周时损伤组出现的挤出或软骨磨损情况，因此6个月组未继续进行修复。本研究表明，虽然半月板损伤对于研究软骨退变很有用，但全面考虑半月板本身的作用，包括其不断变化的材料特性以及在损伤、修复和康复过程中对关节力学的影响，是影响整体关节健康的关键因素。
