EFFECTS OF MENISCECTOMY AND TRANSPLANTATION OF HUMAN KNEE ON STRESS OF TIBIOFEMORAL ARTICULAR SURFACE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANGXishun ¹ ,  ZHANGYadong ² , HOUShuxun ² , WUWenwen ² , ZHANGHong ² , LUODianzhong ² , GUDongqiang ² , ZHAOYantao ²

1. Medical College of Chinese PLA, Beijing, 100853, P. R. China;
2. Orthopaedic Institute of Chinese PLA, the First Affiliated Hospital of General Hospital of Chinese PLA;

Corresponding author：

ZHANGYadong, Email: drzyd@126.com

Keywords：

Meniscus transplantation; Tibiofemoral articular surface; Stress area; Average pressure

DOI：

10.7507/1002-1892.20140005

Video：

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Objective To investigate the effects of meniscectomy and transplantation repair of the knee on the stress area and average pressure of the tibiofemoral articular surface so as to provide a reference for the relevant basic and clinical researches. Methods Seven qualified right knee joints from adult men cadavers were selected. Required structure was retained after careful dissection. The pressure-sensitive paper was clipped to the proper size in accordance with the measured size of the tibial platform to reserve. The experiment was divided into 4 groups: normal knee group (group A), knee meniscus injury group (group B), knee meniscectomy group (group C), and knee meniscus transplantation group (group D). A horizontal incision above the meniscus was made in the position of knee joint capsule, and the pressure-sensitive paper was placed into the medial and lateral space of the knee joint, then the proximal tibia and distal femur were fixed stably and finally a universal mechanical machine was used for testing in appropriate environmental conditions (the knee joints were given longitudinal 700 N pressure at 0° extension and 30, 60, 90, and 120° flexion for continuous 120 seconds) until the full color reaction. The knee models were prepared, and then the universal mechanical machine was used to perform a test according to the method stated above respectively. The pressure-sensitive paper was removed, and the color negative films were separated and marked. Colorful image analysis system was used to calculate and analyze the stress area and average pressure after the scanner being used to collect image information. Results The stress area was gradually reduced and the average pressure was gradually increased with increasing flexion angle of the knee. There was significant difference in the stress area and the average pressure between various flexion angles in 4 groups (P<0.05). Group C had significantly lower stress area and significantly higher average pressure than the other 3 groups (P<0.05), but no significant difference was found among groups A, B, and D (P>0.05). Conclusion The stress of the tibiofemoral articular surface significantly increases after knee meniscus injury or resection, and the average pressure significantly increases. The stress of the tibiofemoral articular surface can be restored to almost normal after meniscus transplantation. Therefore, the injured meniscus should also be retained or repaired in the static state.

Citation： WANGXishun, ZHANGYadong, HOUShuxun, WUWenwen, ZHANGHong, LUODianzhong, GUDongqiang, ZHAOYantao. EFFECTS OF MENISCECTOMY AND TRANSPLANTATION OF HUMAN KNEE ON STRESS OF TIBIOFEMORAL ARTICULAR SURFACE. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(1): 21-25. doi: 10.7507/1002-1892.20140005 Copy

1.	Seedholm BB,Hargreaves DJ.Transmission of the load in the knee joint with special reference to the role of the menisci.Part II:experimental results,discussion and conclusions.Eng Med,1979,8:220-229.
2.	Arnoczky SP,Warren RF.Microvasculature of the human meniscus.Am J Sports Med,1982,10(2):90-95.
3.	Walker PS,Erkman MJ.The role of the menisci in force transmission across the knee.Clin Orthop Relat Res,1975,(109):184-192.
4.	Fairbanks TJ.Knee joint changes after a meniscectomy.J Bone Joint Surg (Br),1948,30B (4):664-670.
5.	Andersson-Molina H,Karlsson H,Rockborn P.Arthroscopic partial and total meniscectomy:a long-term follow-up study with matched controls.Arthroscopy,2002,18(2):183-189.
6.	Cicuttini FM,Forbes A,Yuanyuan W,et al.Rate of knee cartilage loss after partial meniscectomy.J Rheumatol,2002,29(9):1809-1810.
7.	Milachowski KA,Weismeier K,Wirth CJ.Homologous meniscus transplantation.Experimental and clinical results.Int Orthop,1989,13(1):1-11.
8.	章亚东,侯树勋,衷鸿宾,等.膝关节镜下同种异体半月板移植术(附2例初步报告).中国矫形外科杂志,2007,15(10):734-736.
9.	章亚东,侯树勋,张铁超,等.同种异体半月板移植临床效果的初步分析.中华关节外科杂志(电子版),2008,2(6):635-642.
10.	章亚东,侯树勋,张铁超,等.关节镜下异体半月板移植微创手术初步报告.中华创伤骨科杂志,2008,10(3):218-222.
11.	Flanigan DC,Lin F,Koh J,et al.Articular contact pressures of meniscal repair techniques at various knee flexion angles.Orthopedics,2010,33(7):475.
12.	崔一民.半月板的生物学特征及其组织工程化修复的进展.中国创伤骨科杂志,2000,2(1):60-62.
13.	Paletta GA Jr,Manning T,Snell E,et al.The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee.A biomechanical study.Am J Sports Med,1997,25(5):692-698.
14.	Stone KR,Adelson WS,Pelsis JR,et al.Long-term survival of concurrent meniscus allograft transplantation and repair of the articular cartilage:a prospective two-to 12-year follow upreport.J Bone Joint Surg (Br),2010,92(7):941-948.
15.	Harris JD,Cavo M,Brophy R,et al.Biological knee reconstruction:a systematic review of combined meniscal allograft transplantation and cartilage repair or restoration.Arthroscopy,2011,27(3):409-418.
16.	Lee DH,Kim SB,Kim TH,et al.Midterm outcomes after meniscal allograft transplantation:comparison of cases with extrusion versus without extrusion.Am J Sports Med,2010,38(2):247-254.
17.	van der Wal RJ,Thomassen BJ,van Arkel ER.Long-term clinical outcome of open meniscal allograft transplantation.Am J Sports Med,2009,37(11):2134-2139.
18.	Jackon DW,Whelan J,Simon TM.Cell survival after transplantation of fresh meniscal allografts.DNA probe analysis in a goat model.Am J Sports Med,1993,21(4):540-550.
19.	Cummins JF,Mansour JN,Howe Z,et al.Meniscal transplantation and degenerative articular change:An experimental study in the rabbit.Arthroscopy 1997,13(4):485-491.
20.	Jackson DW,McDevitt CA,Simon TM,et al.Meniscal transplantation using fresh and cryopreserved allografts.An experimental study in goats.Am J Sports Med,1992,20(6):644-656.
21.	Mikic ZD,Brankov MZ,Tubic MV,et al.Allograft meniscus transplantation in the dog.Acta Orthop Scand,1993,64(3):329-332.
22.	朱加亮,衷鸿宾,侯树勋,等.异体半月板库的建立及临床初步应用.中国矫形外科杂志,2007,15(19):1445-1447.
23.	Lewis PB,Williams JM.Multiple freeze-thaw cycled meniscal allograft tissue:A biomechanical,biochemical,and histologic analysis.J Orthop Res,2008,26(1):49-55.
24.	Bedi A,Kelly NH,Baad M,et al.Dynamic contact mechanics of the medial meniscus as a function of radial tear,repair,and partial meniscectomy.J Bone Joint Surg (Am),2010,92(6):1398-1408.
25.	von Lewinski G,Stukenborg-Colsman C,Ostermeier S,et al.Experimental measurement of tibiofemoral contact area in a meniscectomized ovine model using a resistive pressure measuring sensor.Ann Biomed Eng,2006,34(10):1607-1614.

1. Seedholm BB,Hargreaves DJ.Transmission of the load in the knee joint with special reference to the role of the menisci.Part II:experimental results,discussion and conclusions.Eng Med,1979,8:220-229.
2. Arnoczky SP,Warren RF.Microvasculature of the human meniscus.Am J Sports Med,1982,10(2):90-95.
3. Walker PS,Erkman MJ.The role of the menisci in force transmission across the knee.Clin Orthop Relat Res,1975,(109):184-192.
4. Fairbanks TJ.Knee joint changes after a meniscectomy.J Bone Joint Surg (Br),1948,30B (4):664-670.
5. Andersson-Molina H,Karlsson H,Rockborn P.Arthroscopic partial and total meniscectomy:a long-term follow-up study with matched controls.Arthroscopy,2002,18(2):183-189.
6. Cicuttini FM,Forbes A,Yuanyuan W,et al.Rate of knee cartilage loss after partial meniscectomy.J Rheumatol,2002,29(9):1809-1810.
7. Milachowski KA,Weismeier K,Wirth CJ.Homologous meniscus transplantation.Experimental and clinical results.Int Orthop,1989,13(1):1-11.
8. 章亚东,侯树勋,衷鸿宾,等.膝关节镜下同种异体半月板移植术(附2例初步报告).中国矫形外科杂志,2007,15(10):734-736.
9. 章亚东,侯树勋,张铁超,等.同种异体半月板移植临床效果的初步分析.中华关节外科杂志(电子版),2008,2(6):635-642.
10. 章亚东,侯树勋,张铁超,等.关节镜下异体半月板移植微创手术初步报告.中华创伤骨科杂志,2008,10(3):218-222.
11. Flanigan DC,Lin F,Koh J,et al.Articular contact pressures of meniscal repair techniques at various knee flexion angles.Orthopedics,2010,33(7):475.
12. 崔一民.半月板的生物学特征及其组织工程化修复的进展.中国创伤骨科杂志,2000,2(1):60-62.
13. Paletta GA Jr,Manning T,Snell E,et al.The effect of allograft meniscal replacement on intraarticular contact area and pressures in the human knee.A biomechanical study.Am J Sports Med,1997,25(5):692-698.
14. Stone KR,Adelson WS,Pelsis JR,et al.Long-term survival of concurrent meniscus allograft transplantation and repair of the articular cartilage:a prospective two-to 12-year follow upreport.J Bone Joint Surg (Br),2010,92(7):941-948.
15. Harris JD,Cavo M,Brophy R,et al.Biological knee reconstruction:a systematic review of combined meniscal allograft transplantation and cartilage repair or restoration.Arthroscopy,2011,27(3):409-418.
16. Lee DH,Kim SB,Kim TH,et al.Midterm outcomes after meniscal allograft transplantation:comparison of cases with extrusion versus without extrusion.Am J Sports Med,2010,38(2):247-254.
17. van der Wal RJ,Thomassen BJ,van Arkel ER.Long-term clinical outcome of open meniscal allograft transplantation.Am J Sports Med,2009,37(11):2134-2139.
18. Jackon DW,Whelan J,Simon TM.Cell survival after transplantation of fresh meniscal allografts.DNA probe analysis in a goat model.Am J Sports Med,1993,21(4):540-550.
19. Cummins JF,Mansour JN,Howe Z,et al.Meniscal transplantation and degenerative articular change:An experimental study in the rabbit.Arthroscopy 1997,13(4):485-491.
20. Jackson DW,McDevitt CA,Simon TM,et al.Meniscal transplantation using fresh and cryopreserved allografts.An experimental study in goats.Am J Sports Med,1992,20(6):644-656.
21. Mikic ZD,Brankov MZ,Tubic MV,et al.Allograft meniscus transplantation in the dog.Acta Orthop Scand,1993,64(3):329-332.
22. 朱加亮,衷鸿宾,侯树勋,等.异体半月板库的建立及临床初步应用.中国矫形外科杂志,2007,15(19):1445-1447.
23. Lewis PB,Williams JM.Multiple freeze-thaw cycled meniscal allograft tissue:A biomechanical,biochemical,and histologic analysis.J Orthop Res,2008,26(1):49-55.
24. Bedi A,Kelly NH,Baad M,et al.Dynamic contact mechanics of the medial meniscus as a function of radial tear,repair,and partial meniscectomy.J Bone Joint Surg (Am),2010,92(6):1398-1408.
25. von Lewinski G,Stukenborg-Colsman C,Ostermeier S,et al.Experimental measurement of tibiofemoral contact area in a meniscectomized ovine model using a resistive pressure measuring sensor.Ann Biomed Eng,2006,34(10):1607-1614.

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EFFECTS OF MENISCECTOMY AND TRANSPLANTATION OF HUMAN KNEE ON STRESS OF TIBIOFEMORAL ARTICULAR SURFACE

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