title: Effect of meniscal loss on knee stability after single-bundle anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  The menisci are known to be important secondary constraints to anterior translation of the tibia in the ACL-deficient knee. The effect of meniscal loss on knee stability as measured by the magnitude of the pivot shift following ACL reconstruction is unknown. The objective of this investigation was to determine the effect of meniscectomy on knee stability following two single-bundle ACL reconstruction strategies.
  
  
  METHODS
  A mechanized pivot shift was performed on cadaveric specimens in the ACL-intact and ACL-deficient state. Tibiofemoral translation was recorded using a surgical navigation system. The ACL was reconstructed utilizing a nonanatomic graft (n = 10) extending from the posterolateral tibial footprint to the anteromedial femoral footprint, or an anatomic anteromedial single-bundle graft extending from the anteromedial tibial footprint to the anteromedial femoral footprint (n = 10) and testing repeated. The medial or lateral meniscus was sectioned and the examination repeated. The other meniscus was sectioned and the examination subsequently repeated.
  
  
  RESULTS
  Lateral compartment translation during the pivot shift was significantly reduced following anatomic ACL reconstruction. In the nonanatomic group, lateral compartment translation increased by 9.1 mm (P < 0.001) after unicomparmental meniscectomy and 11.5 mm (P < 0.001) after bicompartmental meniscectomy. In the anatomic reconstruction group, lateral compartment translation increased by 7.6 mm (P < 0.001) after bicompartmental meniscectomy.
  
  
  CONCLUSIONS
  With isolated ACL injury, anatomic single-bundle ACL reconstruction controlled the pivot shift during time zero testing. However, significant increases in lateral compartment translation during the pivot shift are seen following bicompartmental meniscectomy. Nonanatomic ACL reconstruction was less effective in controlling the pivot shift at time zero testing, and significant increases in lateral compartment translation during the pivot shift were seen following both unicomparmental and bicompartmental meniscectomy.
authors.affiliation: Department of Orthopaedic Surgery, David Geffen School of Medicine, UCLA, 10097 Le Conte Ave., #33-55 PVUB Suite H, Los Angeles, CA 90095, USA. fpetrigliano@mednet.ucla.edu
authors.forename: Frank A
authors.initials: FA
authors.lastname: Petrigliano
authors.forename: Volker
authors.initials: V
authors.lastname: Musahl
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Suero
authors.forename: Musa
authors.initials: M
authors.lastname: Citak
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Pearle
mesh_terms: D000368:Aged; D059549:Anterior Cruciate Ligament Reconstruction; D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology*; D007719:Knee Joint / Q000503:physiopathology*; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D012399:Rotation; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*