Lateral meniscus lesions on stable knee: a prospective multicenter study

Improved tibiofemoral contact restoration after transtibial reinsertion of the anterior root of the lateral meniscus compared to in situ repair: a biomechanical study

PURPOSE

To compare biomechanical behaviour of the anterior root of the lateral meniscus (ARLM) after a transtibial repair (TTR) and after an in situ repair (ISR), discussing the reasons for the efficacy of the more advantageous technique.

METHODS

Eight cadaveric human knees were tested at flexion angles from 0° to 90° in four conditions of their ARLM: intact, detached, reinserted using TTR, and reinserted using ISR. Specimens were subjected to 1000 N of compression, and the contact area (CA), mean pressure (MP), and peak pressure (PP) on the tibial cartilage were computed. For the TTR, traction force on the sutures was registered.

RESULTS

ARLM detachment significantly altered contact biomechanics, mainly at shallow flexion. After ISR, differences compared to the healthy group persisted (extension, CA 22% smaller (p = 0.012); at 30°, CA 30% smaller (p = 0.012), MP 21%, and PP 32% higher (both p = 0.017); at 60°, CA 28% smaller (p = 0.012), MP 32%, and PP 49% higher (both p = 0.025). With TTR, alterations significantly decreased compared to the injured group, with no statistical differences from the intact ones observed, except for CA at extension (15% decrease, p = 0.012) and at 30° (12% decrease, p = 0.017). The suture tension after TTR, given as mean(SD), was 36.46(11.75)N, 44.32(11.71)N, 40.38(14.93)N, and 43.18(14.89)N for the four tested flexion angles.

CONCLUSIONS

Alterations caused by ARLM detachment were partially restored with both ISR and TTR, with TTR showing better results on recovering CA, MP, and PP in the immediate postoperative period. The tensile force was far below the value reported to cause meniscal cut-out in porcine models.

Repair of popliteomeniscal fascicles tear using a posterior transseptal portal fixes hypermobile lateral meniscus

PURPOSE

This study investigates the effects of the all-inside repair of posterosuperior popliteomeniscal fascicle (PMF) on lateral meniscus stabilization using a posterior arthroscopic approach.

METHODS

Between 2015 and 2018, 17 patients with hypermobile lateral meniscus (HLM) underwent posterior knee arthroscopy for PMF repair. The all-inside repair was performed through posteromedial transseptal and posterolateral portals using a suture hook technique. Patients were clinically assessed based on IKDC and Lysholm scores.

RESULTS

Both IKDC and Lysholm scores improved significantly after an average follow-up of 3.5 years (P < 0.001). No patients underwent reoperation, and no complications associated with posterior knee arthroscopy were reported.

CONCLUSION

The all-inside suture hook technique using posterolateral and posteromedial transseptal portals fixes HLM with excellent IKDC and Lysholm scores.

LEVEL OF EVIDENCE

Level IV.

Surgical meniscal lesions in stable knee: Topographic description in a prospective series of 1424 cases

BACKGROUND

The epidemiology of meniscal lesions in stable knee has been a focus of study, but exact topography is not clearly known. Tear patterns are thought to differ between pathologies and the difference between a traumatic and a degenerative pattern is not always easy to draw. In 2010, ISAKOS designed a questionnaire to standardize assessment. The main objective of present study was to detail the precise topography and type of surgical meniscal patterns (i.e., that were operated on) in stable knee. Secondary objectives were to assess the relationship of tear pattern and cartilage lesions in the tibiofemoral compartment, and to analyze age at onset.

HYPOTHESES

The study hypotheses were that tear pattern correlates with cartilage lesions, and that mean age differs according to tear pattern, with younger onset of vertical tears, in surgery@ patients.

PATIENTS & METHODS

Data collection for this descriptive epidemiological study was prospective, on systematic ISAKOS questionnaire. 1424 isolated meniscal tears in stable knee, operated on between 2010 and 2017, were included: 253 lateral meniscus (LM), and 1171 medial meniscus (MM). Mean age at surgery was respectively 36 and 47 years.

RESULTS

The most frequent tear pattern was vertical (39% in LM, 38% in MM). The more frequent locations were posterior+midpart and midpart (22% each) in LM, and posterior in MM (56%). Tears were mainly peripheral (zone 1) in LM (46%), and zone 2 in MM (46%). Mean age in medial vertical tears was 43±14 years, significantly lower (p<0.001) than in other types. Meniscal tear pattern correlated significantly with medial tibiofemoral cartilage lesion (p<0.001).

DISCUSSION

The present study described the precise topography of isolated meniscal tears in stable knee in a large sample, using the ISAKOS questionnaire. The study hypotheses were confirmed for the medial but not the lateral meniscus.

LEVEL OF EVIDENCE

III; well-conducted non-randomized prospective comparative study.

The Menisco-Tibio-Popliteus-Fibular Complex: Anatomic Description of the Structures That Could Avoid Lateral Meniscal Extrusion

PURPOSE

To analyze, quantify, and redefine the anatomy of the peripheral attachments of the lateral meniscal body to further understand how the structures might play a part in preventing meniscal extrusion and how it might be applied to surgical techniques.

METHODS

Ten nonpaired fresh-frozen cadaveric knees without prior injury, a surgical history, or gross anatomic abnormality were included. There were 5 right and 5 left knees, and 50% were from male donors and 50% were from female donors. All the dissections were performed by a group of 3 experts in knee surgery (2 knee surgeons and 1 anatomy professor who oversaw the design of the dissection protocol and guided this protocol). The main peripheral structures associated with the lateral meniscus body were dissected to determine the insertion, size, thickness, and location of the lateral meniscotibial ligament (LMTL), popliteofibular ligament (PFL), and popliteomeniscal ligament (PML). The distance to various landmarks in the lateral compartment was also determined using an electronic caliper. Moreover, a histopathologic study was carried out.

RESULTS

The average thickness of the LMTL was 0.62 ± 0.18 mm (95% confidence interval [CI], 0.49-0.75 mm); that of the PFL-PML area was 1.05 ± 0.27 mm (95% CI, 0.85-1.24 mm). The anteroposterior distance measured 15.80 ± 4.80 mm (95% CI, 12.40-19.30 mm) for the LMTL and 10.40 ± 1.70 mm (95% CI, 9.21-11.63 mm) for the PFL-PML area. The anteroposterior distance of the whole menisco-tibio-popliteus-fibular complex (MTPFC) was 28.20 ± 4.95 mm (95% CI, 24.70-31.70 mm). The average distance from the MTPFC to the posterior horn of the lateral meniscal root was 29.30 ± 2.29 mm (95% CI, 27.60-30.90 mm), whereas that to the anterior horn was 32.00 ± 4.80 mm (95% CI, 28.60-35.50 mm). The average distance from the tibial insertion of the LMTL to the articular surface was 5.59 ± 1.22 mm (95% CI, 4.72-6.46 mm). In all the anatomic components of the knee, a consistent morphologic and histologic pattern was observed between the fibers of the LMTL, PFL, and PML and those of the lateral meniscal body, making up the proposed MTPFC.

CONCLUSIONS

A consistent anatomic pattern has been identified between the lateral meniscal body and the LMTL, PFL, and PML, forming an interconnected complex that would seem appropriate to denominate the MTPFC. A precise study of this region and appropriate nomenclature for it could contribute to a better understanding of the mechanism of lateral meniscal injuries at this level, as well as the development of surgical techniques to treat these lesions and prevent extrusion.

CLINICAL RELEVANCE

This study contributes to the understanding of the lateral meniscal body attachments and the functions they serve. This will lead to improvements in the treatment of lesions in this region, including the development of surgical techniques.

Non anatomic reinsertion after amputation of the anterior horn of the lateral meniscus

Anatomical reinsertion is the optimal treatment for meniscal root injuries. However, in chronic settings, tissue fraying of the meniscal root may impede it. This study describes a salvage technical procedure performed in 3 cases of chronic anterior root avulsion of the lateral meniscus with profuse tissue degeneration in which remnant debridement resulted in amputation of the root. Reinsertion of the meniscus at the remaining healthy tissue was performed using an all-inside anchoring technique.

Quantitative and Qualitative Assessment of Posterolateral Meniscal Anatomy: Defining the Popliteal Hiatus, Popliteomeniscal Fascicles, and the Lateral Meniscotibial Ligament

BACKGROUND

Surgical treatment of lateral meniscal tears can be challenging due to the greater mobility of the lateral meniscus, thin capsule, and management of the popliteal hiatus. There has been a lack of quantitative assessments of the structural attachments to the posterior horn of the lateral meniscus (PHLM) to guide repairs.

PURPOSE

To qualitatively and quantitatively describe the anatomy of the PHLM, popliteomeniscal fascicles, and the posterolateral capsule.

STUDY DESIGN

Descriptive laboratory study.

METHODS

Fourteen male, nonpaired, fresh-frozen cadaveric knees were used. The attachments of the posterolateral capsule, popliteomeniscal fascicles, and meniscofemoral ligaments to the lateral meniscus and the attachment of the meniscotibial ligament to the tibia were identified. A 3-dimensional coordinate measuring system was used to measure the relationships of these attachments to surgically relevant landmarks and their structural relationship with the lateral meniscus.

RESULTS

The posterolateral capsule attachment had a confluent attachment at the superior margin of the PHLM, quantitatively attaching to the proximal 11% of the total height of the PHLM. On average, the length of the posterolateral capsule attachment to the superior surface of the PHLM was 16.7 ± 2.7 mm. The average length of the meniscotibial attachment to the posteroinferior aspect of the meniscus was 12.8 ± 3.9 mm. There was a lack of ligamentous attachments to the lateral meniscus between the lateral aspect of the meniscotibial ligament and the anterior aspect of the anterosuperior popliteomeniscal fascicle, where only popliteomeniscal fascicle and capsular attachments to the posterior meniscus were present.

CONCLUSION

This anatomic study provides quantitative guidelines for the complex attachments to the PHLM. Knowledge of the quantitative descriptions of these attachments may aid in an improved intraoperative diagnosis of PHLM tears that extend to the popliteal hiatus, and further studies related to the surgical repair of the intricate attachments to the PHLM are recommended.

CLINICAL RELEVANCE

The findings of this study provide the anatomic foundation for an improved understanding of the role of the meniscocapsular, meniscotibial, and popliteomeniscal fascicle attachments of the posterolateral meniscus. Understanding the differences between the lengths of the superior and inferior aspects of the popliteal hiatus will help to further refine characterization of tears extending into the popliteal hiatus and to avoid potential overconstraint of the more mobile lateral meniscus during a repair by anatomically reproducing its native structural attachments.

Evaluation of Midterm Clinical and Radiographic Outcomes of Arthroscopically Repaired Vertical Longitudinal and Bucket-Handle Lateral Meniscal Tears

Background:

Lateral meniscal tears in the stable knee are rare. There are few comparative studies evaluating functional and radiological outcomes of vertical longitudinal and bucket-handle lateral meniscal tears.

Purpose:

To evaluate the midterm clinical and radiological outcomes of arthroscopically repaired traumatic vertical longitudinal and bucket-handle lateral meniscal tears.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 43 full-thickness lateral meniscal repairs, including 22 (51.2%) for vertical longitudinal tears and 21 (48.8%) for bucket-handle tears, were evaluated. A clinical assessment was performed according to the Barrett criteria, and patient outcomes were measured with the Lysholm knee score, Tegner activity scale, and overall satisfaction scale. Magnetic resonance imaging was used as the radiological re-examination method preoperatively and at final follow-up. A subgroup analysis examining isolated repair versus repair with concurrent anterior cruciate ligament (ACL) reconstruction was performed.

Results:

The mean follow-up period was 63.2 months (range, 24-86 months). Based on clinical and radiological outcomes, 38 of the 43 repairs (88.3%) were successful, and the remaining 5 (11.6%) cases were considered to be failures. Overall, the combined results for both groups demonstrated an improvement in the Lysholm score, Tegner score, and patient satisfaction. There was no significant difference in the postoperative Lysholm score (91.4 vs 87.0, respectively; P = .223), Tegner score (5.4 vs 5.5, respectively; P = .872), or patient satisfaction (7.2 vs 7.4, respectively; P = .624) between bucket-handle repair and vertical longitudinal repair. The subgroup analysis demonstrated no difference in outcome scores for isolated repair versus repair with concurrent ACL reconstruction. Smoking was identified as a risk factor for repair failure.

Conclusion:

Comparable clinical and radiological outcomes were obtained after vertical longitudinal and bucket-handle lateral meniscal repairs using the all-inside or hybrid suture technique with different suture configurations, regardless of whether ACL reconstruction was performed. Smoking was identified as a risk factor for failure.

[Meniscal lesion. A pre-osteoarthritic condition of the knee joint]

BACKGROUND

A close relationship between meniscal damage and articular cartilage exist. Likewise, (partial) meniscectomy may lead to the development of osteoarthritis (OA).

OBJECTIVES

With a special emphasis on therapeutic consequences for orthopaedic surgeons, the structural and functional relationship between meniscal tears/extrusion and cartilage loss, and/or the effect of meniscectomy or meniscal repair on the development of OA, are emphasized.

MATERIALS AND METHODS

A selective literature review with implementation of own research findings.

RESULTS

The close topographical and functional interplay between the menisci and the tibiofemoral cartilage is the basis for the clinically important relationship between meniscal damage and cartilage degeneration. In particular, due to its close connection to tibiofemoral OA, a degenerative meniscal lesion represents a pre-osteoarthritic condition. Meniscus extrusion is also often associated with tibiofemoral OA. Even large cartilage defects can cause meniscus lesions. Partial meniscectomy is strongly associated with the incidence and risk of progression of OA. Clinical results are particularly problematic after partial resection of the lateral meniscus. Although the use of arthroscopic partial resection for degenerative meniscal lesions has been controversially discussed, no long-term studies are available. A large number of studies emphasize the medium-term value of meniscus reconstruction compared to partial meniscus resection. Combined meniscus and cartilage damage are complex cases, and the value of a simultaneous therapy remains unclear.

CONCLUSIONS

Preserving the meniscus is the first step towards cartilage repair. Randomized and controlled studies will provide better information on the long-term outcomes of meniscal resection and repair with regard to OA development.

Advances in modern osteotomies around the knee : Report on the Association of Sports Traumatology, Arthroscopy, Orthopaedic surgery, Rehabilitation (ASTAOR) Moscow International Osteotomy Congress 2017

Corrective lower limb osteotomies are innovative and efficient therapeutic procedures for restoring axial alignment and managing unicompartmental knee osteoarthritis. This review presents critical insights into the up-dated clinical knowledge on osteotomies for complex posttraumatic or congenital lower limb deformities with a focus on high tibial osteotomies, including a comprehensive overview of basic principles of osteotomy planning, biomechanical considerations of different implants for osteotomies and insights in specific bone deformity correction techniques. Emphasis is placed on complex cases of lower limb osteotomies associated with ligament and multiaxial instability including pediatric cases, computer-assisted navigation, external fixation for long bone deformity correction and return to sport after such osteotomies. Altogether, these advances in the experimental and clinical knowledge of complex lower limb osteotomies allow generating improved, adapted therapeutic regimens to treat congenital and acquired lower limb deformities.

Arthroscopic meniscus repair for recurrent subluxation of the lateral meniscus

PURPOSE

This study was undertaken to diagnose and to document the clinical results and technical aspects of arthroscopic meniscus repair for recurrent subluxation with peripheral tears around the popliteal hiatus of the lateral meniscus.

METHODS

Twenty-three patients (24 knees) with symptomatic recurrent subluxation of the lateral meniscus treated by arthroscopic meniscus repair were included. The inclusion criteria were: (1) patients with knee pain, locking or snapping symptoms despite 3 months of conservative treatment; (2) non-discoid lateral meniscus; (3) stable knee, and (4) tears involving the red-white or red-red zone. All tears were repaired by either the modified all-inside suture technique only or a combination of the modified all-inside and modified outside-in suture techniques. Clinical results were evaluated preoperatively and at final follow-up according to Tegner activity level, Lysholm knee, and Hospital for Special Surgery (HSS) scores.

RESULTS

No reoperations were required after a median follow-up of 41 months (range 24-124). Although recurrence of a locking episode was documented in one knee and catching sensations were experienced in three knees, those patients did not require reoperation. At the last follow-up, the median Tegner activity level had improved significantly from 4 (range 2-6) to 7 (range 3-10, p < 0.0001), the median Lysholm knee score improved from 76 (range 25-90) preoperatively to 94 (range 76-100) at final follow-up (p < 0.0001), and the median preoperative HSS score improved from 86 to 95 at final follow-up (p < 0.0001).

CONCLUSION

The described arthroscopic meniscus suture technique is effective for treating symptomatic recurrent subluxation of the lateral meniscus without any complications or recurrence. Clinical suspicion and understanding of recurrent subluxation with lateral meniscus are important to diagnose the disease especially when definite meniscal tear signs are absent on magnetic resonance imaging.

LEVEL OF EVIDENCE

IV.

Analysis of short and long-term results of horizontal meniscal tears in young adults

INTRODUCTION

Symptomatic horizontal meniscal tears are rare but worrisome lesions in young adults. These are overuse injuries not amenable to the classic arthroscopic sutures. An open meniscal repair allows the meniscal lesion to be suture vertically, perpendicular to its in the vascularized zone. The purpose of this study was to evaluate the short and long-term clinical and radiological outcomes of the aforementioned surgical technique.

MATERIAL AND METHOD

The first cohort consisted of 24 patients operated between 2009 and 2011 (6 women, 18 men; mean age 26years) having 11 lateral and 13 medial meniscal tears. The second cohort was of 10 patients operated between 2001 and 2002 (3 women, 7 men; mean age 24years) having 8 lateral and 2 medial meniscal tears. Patients were reviewed at the last follow-up using the IKDC, Lysholm and KOOS scores. Patients in the first cohort had an MRI, while those in the second cohort had X-rays.

RESULTS

Eighteen patients in the first cohort were reviewed with a mean follow-up of 2 years (12-45 months) and 9 patients from the second cohort were reviewed after 10years (97-142 months). In the first cohort, one patient required secondary menisectomy. The mean Lysholm score was 90 and the subjective IKDC was 85. Every MRI examination found reduced extent and intensity of the hyperintense signal. In the second cohort, no patients required secondary meniscectomy. Two patients had joint space narrowing (less than 50%) on radiographs. The mean Lysholm score was 99 and the subjective IKDC was 91.

CONCLUSION

Open repair of horizontal meniscal tears in young adults leads to good subjective and objective results in the short term, which are maintained in the long-term.

LEVEL OF EVIDENCE

Level IV - retrospective study.

Cost-effectiveness analysis of the diagnosis of meniscus tears

BACKGROUND

Diagnostic imaging represents the fastest growing segment of costs in the US health system. This study investigated the cost-effectiveness of alternative diagnostic approaches to meniscus tears of the knee, a highly prevalent disease that traditionally relies on MRI as part of the diagnostic strategy.

PURPOSE

To identify the most efficient strategy for the diagnosis of meniscus tears.

STUDY DESIGN

Economic and decision analysis; Level of evidence, 1.

METHODS

A simple-decision model run as a cost-utility analysis was constructed to assess the value added by MRI in various combinations with patient history and physical examination (H&P). The model examined traumatic and degenerative tears in 2 distinct settings: primary care and orthopaedic sports medicine clinic. Strategies were compared using the incremental cost-effectiveness ratio (ICER).

RESULTS

In both practice settings, H&P alone was widely preferred for degenerative meniscus tears. Performing MRI to confirm a positive H&P was preferred for traumatic tears in both practice settings, with a willingness to pay of less than US$50,000 per quality-adjusted life-year. Performing an MRI for all patients was not preferred in any reasonable clinical scenario. The prevalence of a meniscus tear in a clinician's patient population was influential. For traumatic tears, MRI to confirm a positive H&P was preferred when prevalence was less than 46.7%, with H&P preferred above that. For degenerative tears, H&P was preferred until the prevalence reaches 74.2%, and then MRI to confirm a negative was the preferred strategy. In both settings, MRI to confirm positive physical examination led to more than a 10-fold lower rate of unnecessary surgeries than did any other strategy, while MRI to confirm negative physical examination led to a 2.08 and 2.26 higher rate than H&P alone in primary care and orthopaedic clinics, respectively.

CONCLUSION

For all practitioners, H&P is the preferred strategy for the suspected degenerative meniscus tear. An MRI to confirm a positive H&P is preferred for traumatic tears for all practitioners. Consideration should be given to implementing alternative diagnostic strategies as well as enhancing provider education in physical examination skills to improve the reliability of H&P as a diagnostic test.

CLINICAL RELEVANCE

Alternative diagnostic strategies that do not include the use of MRI may result in decreased health care costs without harm to the patient and could possibly reduce unnecessary procedures.

Arthroscopic repair of bucket-handle tears of the lateral meniscus

PURPOSE

This study was undertaken to document the clinical results of arthroscopic meniscus repair for treatment of displaced bucket-handle tears of the lateral meniscus.

METHODS

From 2002 to 2010, 13 patients with symptomatic displaced bucket-handle tears of the lateral meniscus treated by arthroscopic meniscus repair were included in this study. Inclusion criteria were (1) displaced bucket-handle tear of the lateral meniscus demonstrated on magnetic resonance imaging, (2) non-discoid lateral meniscus, (3) stable knee, and (4) tears involving the red-white or red-red zone. Median age at operation was 20 years (range 14-54 years), and the median follow-up period was 4.0 years (range 2-10.7 years). All tears were repaired with either a modified all-inside suture technique only or a combination of the modified all-inside suture and modified outside-in techniques. Clinical results were evaluated preoperatively and at the final follow-up using Tegner activity level, Lysholm knee, and Hospital for Special Surgery (HSS) scores.

RESULTS

All patients returned to their prior life activities with little or no limitations, and no reoperations were required during the follow-up period. On the final follow-up, all knees achieved full range of motion, except two knees with limited function during squatting and jumping due to pain. No patient had recurrence of a knee-locking episode. The median Tegner activity level improved significantly from 3 (2-6) to 7 (4-9) (p < 0.0001), mean Lysholm knee score improved from 78.5 ± 10.7 preoperatively to 94.6 ± 5.4 (p < 0.0001), and mean preoperative HSS score improved from 80.3 ± 8.5 to 95.9 ± 4.2 (p < 0.0001) during the follow-up period.

CONCLUSION

Arthroscopic meniscus repair using the modified all-inside suture and modified outside-in techniques showed excellent clinical outcomes for treatment of symptomatic displaced bucket-handle tears of the lateral meniscus and were free of any complications or episodes of recurrence.

LEVEL OF EVIDENCE

Case series, Level IV.

Effect of open wedge high tibial osteotomy on the lateral tibiofemoral compartment in sheep. Part II: standard and overcorrection do not cause articular cartilage degeneration

PURPOSE

To evaluate whether medial open wedge high tibial osteotomy (HTO) results in structural changes in the articular cartilage in the lateral tibiofemoral compartment of adult sheep.

METHODS

Three experimental groups received biplanar osteotomies of the right proximal tibiae: (a) closing wedge HTO (4.5° of tibial varus), (b) opening wedge HTO (4.5° tibial valgus; standard correction), and (c) opening wedge HTO (9.5° of valgus; overcorrection), each of which was compared to the contralateral knees that only received an arthrotomy. After 6 months, the macroscopic and microscopic characteristics of the articular cartilage of the lateral tibiofemoral compartment were assessed.

RESULTS

The articular cartilage in the central region of the lateral tibial plateau in sheep had a higher safranin O staining intensity and was 4.6-fold thicker than in the periphery (covered by the lateral meniscus). No topographical variation in the type-II collagen immunoreactivity was seen. All lateral tibial plateaus showed osteoarthritic changes in regions not covered by the lateral meniscus. No osteoarthritis was seen in the peripheral submeniscal regions of the lateral tibial plateau and the lateral femoral condyle. Opening wedge HTO resulting in both standard and overcorrection was not associated with significant macroscopic and microscopic structural changes between groups in the articular cartilage of the lateral tibial plateau and femoral condyle after 6 months in vivo.

CONCLUSION

Opening wedge HTO resulting in both standard and overcorrection is a safe procedure for the articular cartilage in an intact lateral tibiofemoral compartment of adult sheep at 6 months postoperatively.

Landing adaptations following isolated lateral meniscectomy in athletes

PURPOSE

Objective functional outcomes following isolated radial lateral meniscus tears in the athlete between the ages of 14-25 are not clearly defined. The objective of this study was to determine whether patients following lateral meniscectomy demonstrate lower extremity asymmetries relative to control athletes 3 months after surgery. We hypothesized that following lateral meniscectomy, athletes aged 14-25 years old would demonstrate altered landing biomechanics compared to sex, age, height, weight, and sport-matched controls.

METHODS

A total of 18 subjects were included in this study. Nine patients (7 men and 2 women, 20.1 ± 2.8 years) who had undergone first-time isolated radial lateral meniscus tears were tested 3 months following partial lateral meniscectomies and compared to nine sex, age, height, weight, and sport-matched controls (7 men and 2 women, 19.7 ± 3.1 years). A ten-camera motion analysis system and two force platforms were used to collect three trials of bilateral drop landings. A 2X2 ANOVA was used to test the interaction between side (involved vs. uninvolved) and group (patient vs. control).

RESULTS

The patient group landed with a decreased internal knee extensor moment compared to the uninvolved side and controls (interaction P < 0.05). The involved limb quadriceps isokinetic torque was not decreased compared to the contralateral or control (n.s.). Decreased knee extensor moments were significantly associated with reduced measures of function (IKDC scores: r = 0.69; P < 0.05).

CONCLUSIONS

Athletes who return to sport at approximately 3 months following a partial lateral meniscectomy may employ compensation strategies during landing as evidenced by reduced quadriceps recruitment and functional outcome scores. Clinicians should focus on improving quadriceps function during landing on the involved leg in an attempt to decrease residual limb asymmetries.

LEVEL OF EVIDENCE

Case-control study, Level III.