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Shen X, Lu M, Liu M, Xie R, Gong S, Yang C, Sun G. Effect of residual volume after surgery of the discoid lateral meniscus on tibiofemoral joint biomechanics: a finite element analysis. J Orthop Surg Res 2024; 19:43. [PMID: 38184619 PMCID: PMC10771657 DOI: 10.1186/s13018-023-04522-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/30/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND The purpose of this study was to investigate the influence of different residual meniscus volume on the biomechanics of tibiofemoral joint after discoid lateral meniscus (DLM) surgery by finite element analysis. METHODS A knee joint model was established based on CT and MRI imaging data. The DLM model was divided into five regions according to conventional meniscectomy, with volumes of 15%, 15%, 15%, 15%, 15%, and 40% for each region. Additionally, the DLM model was divided into anterior and posterior parts to obtain ten regions. The DLM was resected according to the design scheme, and together with the intact discoid meniscus, a total of 15 models were obtained. Finite element analysis was conducted to assess shear and pressure trends on the knee joint. RESULTS The study observed significant changes in peak shear stress and compressive stress in the lateral meniscus and lateral femur cartilage. As the meniscus volume decreased, there was an increase in these stresses. Specifically, when the meniscus volume reduced to 40%, there was a sharp increase in shear stress (302%) and compressive stress (152%) on the meniscus, as well as shear stress (195%) and compressive stress (157%) on the lateral femur cartilage. Furthermore, the model grouping results showed that preserving a higher frontal volume in the meniscus model provided better biomechanical advantages. CONCLUSION The use of finite element analysis has demonstrated that preserving more than 55% of the meniscus volume is necessary to prevent a significant increase in joint stress, which can potentially lead to joint degeneration. Additionally, it is crucial to preserve the front volume of the DLM in order to achieve improved knee biomechanical outcomes.
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Affiliation(s)
- Xin Shen
- Department of Sports Medicine, Orthopaedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwai Zhengjie, Donghu District, Nanchang City, Jiangxi Province, China
- Department of Osteoarthrosis, The First People's Hospital of Jiujiang, Jiujiang City, Jiangxi Province, China
| | - Meifeng Lu
- Department of Sports Medicine, Orthopaedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwai Zhengjie, Donghu District, Nanchang City, Jiangxi Province, China
| | - Muzi Liu
- Department of Osteoarthrosis, The First People's Hospital of Jiujiang, Jiujiang City, Jiangxi Province, China
| | - Ronghui Xie
- Department of Osteoarthrosis, The First People's Hospital of Jiujiang, Jiujiang City, Jiangxi Province, China
| | - Shiguo Gong
- Department of Osteoarthrosis, The First People's Hospital of Jiujiang, Jiujiang City, Jiangxi Province, China
| | - Chunjing Yang
- Department of Medical Imaging, The First People's Hospital of Jiujiang, Jiujiang City, Jiangxi Province, China
| | - Guicai Sun
- Department of Sports Medicine, Orthopaedic Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, No. 17, Yongwai Zhengjie, Donghu District, Nanchang City, Jiangxi Province, China.
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Rohde MS, Trivedi S, Randhawa S, Wright CE, Vuong BB, Pham N, Stavinoha T, Ellis HB, Ganley TJ, Green DW, Fabricant PD, Tompkins M, Shea KG. Pediatric meniscus morphology varies with age: a cadaveric study. Knee Surg Sports Traumatol Arthrosc 2023; 31:4179-4186. [PMID: 37178242 DOI: 10.1007/s00167-023-07447-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE In adolescent patients, meniscal tear injury can occur either in isolation (e.g., discoid lateral meniscus tears) or in association with other traumatic injuries including tibial eminence fracture or ACL tear. Damage to meniscal integrity has been shown to increase contact pressure in articular cartilage, increasing risk of early onset osteoarthritis. In symptomatic patients failing conservative management, surgical intervention via meniscus repair or meniscus transplant is indicated. The purpose of this study was to evaluate the radial dimensions of pediatric menisci throughout development. The hypothesis was that the average radial meniscus dimensions will increase as specimen age increases, and mean medial and lateral region measurements will increase at a linear rate. METHODS Seventy-eight skeletally immature knee cadaver specimens under age 12 years were included in this study. The meniscal specimens were photographed in the axial view with ruler in the plane of the tibial plateau and analyzed using computer-aided design (CAD) software (Autodesk Fusion 360). Measurements were taken from inner to outer meniscus rims at five 45 degree intervals using the clockface as a reference (12:00, 1:30, 3:00, 4:30, 6:00), and total area of meniscus and tibial plateau was recorded. Generalized linear models were used to evaluate the associations of radial width measurements with age, tibial coverage, and lateral vs. medial meniscus widths. RESULTS All radial width measurements increased significantly with specimen age (p ≤ 0.002), and all lateral-medial meniscal widths increased (p < 0.001). The anterior zones of the meniscus were found to increase at the slowest rate compared to other regions. Tibial plateau coverage was found to not significantly vary with age. CONCLUSIONS Meniscus radial width and lateral-medial meniscus width are related to age. The anterior width of the meniscus varied least with age. Improved anatomic understanding may help surgeons more effectively plan for meniscus repair, discoid resection/saucerization/repair, and also support appropriate selection of meniscus allograft for transplantation.
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Affiliation(s)
- Matthew S Rohde
- Department of Orthopedic Surgery, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA.
| | - Sunny Trivedi
- Department of Orthopedic Surgery, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
| | - Sahej Randhawa
- Department of Orthopedic Surgery, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
| | - Christian E Wright
- Department of Orthopedic Surgery, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
| | - Brian B Vuong
- Department of Orthopedic Surgery, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
| | - Nicole Pham
- Department of Orthopedic Surgery, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
| | | | | | | | | | | | - Marc Tompkins
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Kevin G Shea
- Department of Orthopedic Surgery, Stanford University School of Medicine, 453 Quarry Road, Stanford, Palo Alto, CA, 94304, USA
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Liu W, Sun X, Liu W, Liu H, Zhai H, Zhang D, Tian F. Finite element study of a partial meniscectomy of a complete discoid lateral meniscus in adults. Med Eng Phys 2022; 107:103855. [DOI: 10.1016/j.medengphy.2022.103855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 06/02/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
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