Influence of lateral meniscal posterior root avulsions and the meniscofemoral ligaments on tibiofemoral contact mechanics
Influence of lateral meniscal posterior root avulsions and the meniscofemoral ligaments on tibiofemoral contact mechanics
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DOI：
10.1007/s00167-015-3742-1
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发表时间：
2016-05-01
影响因子：
3.8
通讯作者：
LaPrade, Robert F.
中科院分区：
文献类型：
--
作者：
Geeslin, Andrew G.;Civitarese, David;LaPrade, Robert F.
本研究的目的是使用既定的胫股接触力学测试方案，研究外侧半月板后根撕脱结合完整的半月板股韧带 (MFL)、MFL 缺陷、前十字韧带 (ACL) 撕裂和重建以及根部修复的效果。 在 6 种膝关节状况下对 10 个新鲜冰冻的尸体膝盖进行了测试（1：完整；2：外侧半月板后根）撕脱；3：根部撕脱和 MFL 缺陷；4：情况 3 伴有 ACL 撕裂；5：情况 4 进行 ACL 重建；6：ACL 重建并进行根部修复），在 1000 N 轴向载荷下，五个屈曲角度（0A 度、30A 度、45A 度、60A 度和 90A 度）。使用 Tekscan 传感器测量接触面积和压力。与完整状态相比，条件 2 没有显着改变侧室接触面积或压力。弯曲角度增加时，接触力学的变化更大；对于条件 3，0A 度和 90A 度，接触面积分别减少 37% 和 52% [95% CI (21-53) 和 (39-66)]，平均接触压力分别增加 55 % 和 87% [95% CI (33-76) 和 (59-114)]。 ACL 重建的牙根修复与完整状态没有显着差异。在外侧半月板后根撕脱的情况下，MFL 保护外侧间室免受接触力学变化的影响，而外侧半月板根部撕脱和 MFL 缺陷的组合会导致显着的变化。同时进行 ACL 重建和外侧半月板根部修复可将平均接触压力和面积恢复到完整状态，建议在这种复合损伤中预防或减缓外侧间室关节炎的发展。
The purpose of this study was to investigate the effect of lateral meniscal posterior root avulsions combined with intact meniscofemoral ligaments (MFLs), deficient MFLs, anterior cruciate ligament (ACL) tears and reconstructions, and root repairs using an established tibiofemoral contact mechanics testing protocol.Ten fresh-frozen cadaveric knees were tested with six knee conditions (1: intact; 2: lateral meniscal posterior root avulsion; 3: root avulsion and deficient MFLs; 4: condition 3 with ACL tear; 5: condition 4 with ACL reconstruction; 6: ACL reconstruction with root repair) at five flexion angles (0A degrees, 30A degrees, 45A degrees, 60A degrees, and 90A degrees), under a 1000-N axial load. Contact area and pressure were measured with Tekscan sensors.Compared to the intact state, condition 2 did not significantly change lateral compartment contact area or pressure. Changes in contact mechanics were greater at increased flexion angles; for condition 3 at 0A degrees and 90A degrees, contact area decreased 37 and 52 % [95 % CI (21-53) and (39-66), respectively] and mean contact pressure increased 55 and 87 % [95 % CI (33-76) and (59-114), respectively]. Root repair with ACL reconstruction was not significantly different from the intact state.The MFLs protect the lateral compartment from changes in contact mechanics in the setting of a lateral meniscal posterior root avulsion, whereas a combination of lateral meniscal root avulsion and deficient MFLs leads to significant changes. Concurrent ACL reconstruction and lateral meniscal root repair restore mean contact pressure and area to the intact state and are recommended in this combined injury to prevent or slow the development of lateral compartment arthritis.