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Title:

Varus alignment aggravates tibiofemoral contact pressure rise after sequential medial meniscus resection

Document type:
Article
Author(s):
Willinger, Lukas; Lang, Jan J.; Berthold, Daniel; Muench, Lukas N.; Achtnich, Andrea; Forkel, Philipp; Imhoff, Andreas B.; Burgkart, Rainer; von Deimling, Constantin
Abstract:
Background Partial meniscectomy and varus alignment are considered independent risk factors for increased medial compartment load, thus contributing to the development of medial osteoarthritis. The purpose of this biomechanical study was to investigate the effect of lower limb alignment on contact pressure and contact area in the knee joint following sequential medial meniscus resection. Material and methods In this study eight freshly frozen human cadaveric knees were axially loaded with a 750& x202f; N compressive force in full extension with the mechanical axis rotated to intersect the tibial plateau at 30%, 40%, 50%, 60% and 70% of its width. Tibiofemoral mean contact pressure (MCP), peak contact pressure (PCP), and contact area (CA) of the medial and lateral compartments were measured separately using pressure sensitive films (K-Scan 4000, Tekscan) in four different meniscal conditions: intact, 50% resection, 75% resection, and total meniscectomy. Results The medial MCP was significantly increased when comparing the intact meniscus to each meniscal resection in all tested alignments (p& x202f; < 0.05). Following meniscal resection of 50%, the MCP was significantly higher with greater varus alignment compared to valgus alignment (p& x202f; < 0.05). Similarly, the medial PCP was higher with varus alignment compared to valgus alignment (p& x202f; < 0.05). The medial CA of the intact meniscus decreased significantly after 50%, 75% and 100% meniscal resection in all alignments (p& x202f; < 0.05). Conclusion Lower limb alignment and the extent of medial meniscal resection significantly affect tibiofemoral contact pressure. Combined varus alignment and medial meniscal resection increased the MCP and PCP within the medial compartment, whereas valgus alignment prevented medial overload.
Journal title abbreviation:
ARTHROSKOPIE
Year:
2020
Journal volume:
33
Journal issue:
2
Pages contribution:
94-98
Fulltext / DOI:
doi:10.1007/s00142-020-00344-8
Print-ISSN:
0933-7946
TUM Institution:
Fachgebiet Sportorthopädie (Prof. Imhoff); Klinik und Poliklinik für Orthopädie und Sportorthopädie
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