title: Comparative Biomechanical Study on Contact Alterations After Lateral Meniscus Posterior Root Avulsion, Transosseous Reinsertion, and Total Meniscectomy.
abstract: OBJECTIVE
  To compare the effects of lateral meniscus posterior root avulsion left in situ, its repair, and meniscectomy on contact pressure distribution in both tibiofemoral compartments at different flexion angles.
  
  
  METHODS
  Eight cadaveric knees were tested under compressive 1000 N load for 4 lateral meniscus conditions (intact, posterior root avulsion, transosseous root repair, and total meniscectomy) at flexion angles 0°, 30°, 60°, and 90°. Contact area and pressure distribution were registered using K-scan pressure sensors inserted between menisci and tibial plateau.
  
  
  RESULTS
  In the lateral compartment, root detachment decreased contact area (P = .017, 0° and 30°; P = .012, 60° and 90°) and increased mean (P = .012, all angles) and maximum (P = .025, 0° and 30°; P = .017, 60°; P = .012, 90°) pressures relative to intact condition. Repair restored all measured parameters close to intact at 0°, but effectiveness decreased with flexion angle, yielding no significant effect at 90°. Meniscectomy produced higher decreases than root avulsion in contact area (P = .012, 0° and 90°; P = .05, 30° and 60°) and increases in mean (P = .017, 0° and 30°; P = .018, 90°) and maximum pressure (P = .012, 0°; P = .036, 30°). In the medial compartment, lesion changed the contact area at high flexion angles only, while meniscectomy induced greater changes at all angles.
  
  
  CONCLUSIONS
  Lateral meniscus posterior root avulsion generates significant alterations in contact area and pressures at lateral knee compartment for flexion angles between full extension and 90°. Meniscectomy causes greater disorders than the avulsion left in situ. Transosseous repair with a single suture restores these alterations to conditions close to intact at 0° and 30° but not at 60° and 90°.
  
  
  CONCLUSIONS
  Altered contact mechanics after lateral meniscus posterior root avulsion might have degenerative consequences. Transosseous repair with one suture should be revised to effectively restore contact mechanics at high flexion angles.
authors.affiliation: Biomechanics Laboratory, Department of Mechanical Engineering, University of Malaga, Malaga, Spain. Electronic address: anaperez@uma.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Perez-Blanca
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Virgen de la Victoria, Malaga, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Espejo-Baena
authors.affiliation: Department of Anatomy and Forensic Medicine, University of Malaga, Malaga, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Amat Trujillo
authors.affiliation: Biomechanics Laboratory, Department of Mechanical Engineering, University of Malaga, Malaga, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Prado Nóvoa
authors.affiliation: Hospital Vithas Parque San Antonio, Malaga, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Espejo-Reina
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Virgen de la Victoria, Malaga, Spain.
authors.forename: Clara
authors.initials: C
authors.lastname: Quintero López
authors.affiliation: Biomechanics Laboratory, Department of Mechanical Engineering, University of Malaga, Malaga, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Ezquerro Juanco
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D011312:Pressure; D016059:Range of Motion, Articular; D012092:Replantation / Q000379:methods*; D013537:Sutures; D000070600:Tibial Meniscus Injuries