title: Releasing the circumferential fixation of the medial meniscus does not affect its kinematics.
abstract: BACKGROUND
  Meniscal functioning depends on the fixation between the meniscal horns and the surrounding tissues. It is unknown, however, whether the integration between the outer circumference of the medial meniscus and the knee capsule/medial collateral ligament also influences the biomechanical behavior of the meniscus. Therefore, we aimed to determine whether detaching and resuturing the circumferential fixation of the medial meniscus influence its kinematic pattern.
  
  
  METHODS
  Human cadaveric knee joints were flexed (0°-30°-60°-90°) in a knee loading rig, in neutral orientation and under internal and external tibial torques. Roentgen stereophotogrammetric analysis was used to determine the motion of the meniscus in anteroposterior (AP) and mediolateral (ML) directions. Three fixation conditions were evaluated: (I) intact, (II) detached and (III) resutured.
  
  
  RESULTS
  Detaching and resuturing the circumferential fixation did not alter the meniscal motion pattern in either the AP or ML direction. Applying an additional internal tibial torque caused the medial meniscus to move slightly anteriorly, and an external torque caused a little posterior translation with respect to the neutral situation. These patterns did not change when the circumferential fixation condition was altered.
  
  
  CONCLUSIONS
  This study demonstrated that the motion pattern of the medial meniscus is independent of its fixation to the knee capsule and medial collateral ligament.
  
  
  CONCLUSIONS
  The outcomes of this study can be deployed to design the fixation strategy of a permanent meniscus prosthesis. As peripheral fixation is a complicated step during meniscal replacement, the surgical procedure is considerably simplified when non-resorbable implants do not require circumferential fixation.
authors.affiliation: Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: Anne.Vrancken@radboudumc.nl.
authors.forename: A C T
authors.initials: AC
authors.lastname: Vrancken
authors.affiliation: Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Orthopaedic Surgery, Via Sana Clinic, Mill, The Netherlands.
authors.forename: T G
authors.initials: TG
authors.lastname: van Tienen
authors.affiliation: Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Hannink
authors.affiliation: Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Janssen
authors.affiliation: Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands; Laboratory for Biomechanical Engineering, University of Twente, Enschede, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Verdonschot
authors.affiliation: Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Buma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D059869:Radiostereometric Analysis; D016059:Range of Motion, Articular / Q000502:physiology*
keywords: Circumferential fixation; Kinematics; Medial meniscus