Partial medial meniscectomy and rotational differences at the knee during walking.
Loss of meniscal function due to injury or partial meniscectomy is common and represents a significant risk factor for premature osteoarthritis. The menisci can influence the transverse plane movements (anterior-posterior (AP) translation and internal-external (IE) rotation) of the knee during walking. While walking is the most frequent activity of daily living, the kinematic differences at the knee during walking associated with the meniscal injury are not well understood. This study examined the influence of partial medial meniscectomy (PMM) on the kinematics and kinetics of the knee during the stance phase of gait by testing the differences in anterior-posterior translation, internal-external rotation, knee flexion range of movement, peak flexion/extension moments, and adduction moments between the PMM and healthy contralateral limbs. Ten patients (45±9 years old, height 1.75±0.06m, weight 76.7±13.5kg) who had undergone partial medial meniscectomy (33±100 months post-op) in one limb with a healthy contralateral limb were tested during normal walking. The contralateral limb was compared to a matched control group and no differences were found. The primary kinematic difference was a significantly greater external rotation (3.2°) of the tibia that existed through stance phase, with 8 of 10 subjects demonstrating the same pattern. The PMM subjects also exhibited significantly lower peak flexion and extension moments in their PMM limbs. The altered rotational position found likely results in changes of tibio-femoral contact during walking and could cause the type of degenerative changes found in the articular cartilage following meniscal injury.
Netravali
Nathan A
NA
Bone and Joint Center, Palo Alto VA, Palo Alto, CA, USA. nan4@stanford.edu
Giori
Nicholas J
NJ
Andriacchi
Thomas P
TP
D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008592:Menisci, Tibial / Q000503:physiopathology* / Q000601:surgery*; D008875:Middle Aged; D008954:Models, Biological; D020370:Osteoarthritis, Knee / Q000209:etiology; D016059:Range of Motion, Articular / Q000502:physiology; D012399:Rotation; D000070600:Tibial Meniscus Injuries; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology