1
|
Çakır GH, Mutlu İ. A comparison of stress, contact pressure, and contact area on menisci in re-injury mechanisms after reconstruction of the anterior cruciate ligament with autograft and synthetic graft: a finite element study. INTERNATIONAL ORTHOPAEDICS 2023; 47:2487-2496. [PMID: 37449986 DOI: 10.1007/s00264-023-05881-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE The anterior cruciate ligament (ACL) is crucial in maintaining knee stability. Some motion mechanisms, which are common in sports, cause excessive load to be passed on the ACL. In non-contact ACL injuries, the ACL cannot sustain the high stress and becomes injured or ruptures in the valgus-external rotation mechanism (VERM) and varus-internal rotation mechanism (VIRM). The mechanical strength of the grafts used to repair the torn ligament varies. The purpose of this study is to look at the alterations in the menisci after anterior cruciate ligament repair with autografts and synthetic grafts in cases of non-contact re-injury mechanisms. METHODS In the finite element analysis, VERM and VIRM motions of the injury were simulated with different ACL graft materials. During the simulations of these mechanism motions with polyethylene terephthalate (PET) and patellar tendon (PT), the contact pressures, contact areas, and von mises stress values created in the medial and lateral meniscus were compared. RESULTS The peak contact pressures on the menisci during the VERM are higher than the peak contact pressures during the VIRM, except for one variation. The peak contact pressure of the medial meniscus is almost the same for both graft materials and mechanisms. Furthermore, the peak contact pressures in the menisci are higher than in the VERM. For all injury mechanisms, the peak contact stresses on the lateral meniscus are higher than on the medial meniscus. CONCLUSIONS The findings suggest that VERM can induce further knee joint injury. It was found that the PET will lessen the pressure on the menisci even more. It is also advantageous since it does not damage the anterior extremities and transmits less pressure to the menisci. In conclusion, using a high-strength ACL is healthier for the menisci. Even though synthetic grafts are not clinically preferred, the study demonstrates that enhancing the material properties of synthetic grafts will increase the chance of their use in the future, based on the current results.
Collapse
Affiliation(s)
- Gül Hilal Çakır
- Department of Biomedical Engineering, Kocaeli University, Umuttepe Campus, Izmit, Kocaeli, Turkey.
| | - İbrahim Mutlu
- Department of Biomedical Engineering, Kocaeli University, Umuttepe Campus, Izmit, Kocaeli, Turkey
| |
Collapse
|
2
|
Choi NH, Yang BS, Lee DM, Lee JS, Victoroff BN. Correlation Between Anatomic Landmarks and Bony Trough Position in Lateral Meniscal Allograft Transplant. Orthop J Sports Med 2022; 10:23259671221117531. [PMID: 36051973 PMCID: PMC9425904 DOI: 10.1177/23259671221117531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/12/2022] [Indexed: 11/15/2022] Open
Abstract
Background Determining the rotational axis of the bony trough during lateral meniscal allograft transplant (MAT) is difficult. The use of anatomic landmarks may help a surgeon determine the rotational alignment of the graft during the procedure. Purpose To investigate the association between the knee's anatomic landmarks and the position of the bony trough to prevent extrusion after lateral MAT. Study Design Cross-sectional study; Level of evidence, 3. Methods Enrolled were 44 patients who underwent lateral MAT between July 2000 and February 2011. The patients' mean age at the time of surgery was 30.8 years. Extrusion was measured on magnetic resonance imaging (MRI) scans at a mean of 3.6 months postoperatively, and patients were divided into an extrusion group (n = 15) and a no-extrusion group (n = 29). Three coronal MRI scans from each patient were selected, each from the region at the level of the tibial tuberosity (TT), the anterior bony trough, and the posterior bony trough. We measured the distance between the center of the anterior bony trough and the center of the TT (the TT distance) and the distance between the center of the posterior bony trough and the medial border of the lateral femoral condyle (LFC) (the LFC distance). Results The mean center of the anterior bony trough was in a more medial position relative to the center of the TT in the no-extrusion group (-2.9 ± 4.8 mm) compared with the extrusion group (1.3 ± 4.9 mm; P = .010). The mean center of the posterior bony trough was in a more medial position relative to the medial border of the LFC in the no-extrusion group (-1.7 ± 3.9 mm) compared with the extrusion group (1.0 ± 3.2 mm; P = .027). Both TT distance and LFC distance were significantly correlated with extrusion (P = .005 and .025, respectively). The cutoff value was -0.24 mm for the anterior bony trough and -0.58 mm for the posterior bony trough (negative values indicate that the trough was medial to the respective landmarks). Conclusion To prevent extrusion of the allograft, the center of the anterior bony trough needs to be aligned with the center of the TT, and the center of the posterior bony trough needs to be aligned with the medial border of the LFC.
Collapse
Affiliation(s)
- Nam-Hong Choi
- Department of Orthopedic Surgery, Eulji Medical Center, Seoul, Republic of Korea
| | - Bong-Seok Yang
- Department of Orthopedic Surgery, Shihwa Medical Center, Siheung, Republic of Korea
| | - Dong-Min Lee
- Department of Orthopedic Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Republic of Korea
| | - Jong-Seok Lee
- Department of Orthopedic Surgery, Gwangmyeong Sungae Hospital, Gwangmyeong, Republic of Korea
| | - Brian N Victoroff
- Department of Orthopedic Surgery, Case Western Reserve University, Cleveland, Ohio, USA
| |
Collapse
|
3
|
An anatomical study of the meniscal roots of the knee: landmarks for its surgical reconstruction and implications for knee surgeons. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:971-977. [PMID: 35780197 DOI: 10.1007/s00276-022-02979-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/16/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE The aim of this anatomical study was to describe the anatomy of the meniscal roots and their relationships with respect to the main adjacent structures in order to improve their surgical reconstruction. METHODS Fourteen knees were included. The mean age of the donors was 92 years (range 89-96). We studied the general characteristics of the anterior and posterior roots of the medial meniscus and lateral meniscus by measuring their widths at their base and area. We investigated the relations between anterior and posterior roots of the medial and lateral menisci with respect to the anterior and posterior cruciate ligaments (ACL and PCL). RESULTS The mean width of the anterior root of the lateral meniscus was 10.5 ± 1.4 mm. The mean width of the anterior root of the medial meniscus was 10 ± 1.5 mm. The mean width of the posterior root of lateral meniscus was 11.4 ± 1.4 mm. The mean width of the posterior root of medial meniscus was 10.5 ± 1.0 mm. The mean distance between the anterior cruciate ligament and the anterior root of lateral meniscus was 9.8 ± 2.9 mm, for the medial meniscus it was 15.9 ± 3.4 mm. The mean distance between the posterior cruciate ligament and the posterior root of the lateral meniscus was 11.5 ± 2.7 mm, for the medial meniscus, it was 11 ± 2.6 mm. CONCLUSION The anterior and posterior meniscal roots have precise landmarks, and this article contributes to define the location of the meniscal roots with respect to their adjacent anatomical structures: ACL, PCL and intercondylar tubercle. Having precise measures of the distances between the meniscus roots and these structures allows knee surgeons to perform ACL reconstruction, meniscal root repair and meniscal allograft transplantation.
Collapse
|
4
|
Qi YS, Bao HRC, Tao LY, Gu PL, Kong CLM, Wang JC, Xu YS. The Effects of Lateral Meniscus Posterior Root Tear and its Repair on Knee Stability of Internal Rotation and Forward Shift: A Biomechanical Kinematics Cadaver Study. Front Bioeng Biotechnol 2022; 9:792894. [PMID: 35127667 PMCID: PMC8807685 DOI: 10.3389/fbioe.2021.792894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Lateral meniscal posterior root (LMPR) is an important stabilizer for knee joint, providing the stability during tibia forward shifting and internal rotating. It is still controversial that whether the LMPR tear (LMPRT) should be repaired together with ACL reconstruction. This study aims to investigate the effects of LMPR on knee stability with intact ACL.Methods: Eight cadaver knees were used and performed the biomechanical kinematics tests in orders of: Group A: the LMPR was intact; Group B: the LMPR was cut off from its tibial end; Group C: the LMPRT has been repaired. 1) An internal rotation moment (5 Nm) was given to the tibia, then the internal rotation angle of the tibia was measured; 2) An forward shifting force (134 N) was given to the tibia, then the anterior displacement of the tibia was measured; 3) An internal rotation moment (5 Nm) and a valgus moment (10 Nm) were given to the tibia, then the internal rotation angle and the anterior displacement was measured. The stability was inferred from smaller rotation angle and displacement, and all of the angles and displacements were measured at knee flexion of 0°, 30°, 60° and 90°, respectively.Results: Comparing to Group A, the internal rotation angle in Group B was increased significantly at knee flexion of 30° (p = 0.025), 60° (p = 0.041), 90° (p = 0.002); the anterior tibia displacement in Group B was increased significantly at knee flexion of 30° (p = 0.015), 60° (p = 0.024); at knee valgus, the internal rotation angle was also increased significantly at knee flexion of 60° (p = 0.011), 90° (p = 0.037). Comparing to Group B, the internal rotation angle in Group C was decreased significantly at knee flexion of 30° (p = 0.030), 60° (p = 0.019), 90° (p = 0.021); the anterior displacement in Group C was decreased significantly at knee flexion of 30° (p = 0.042), 60° (p = 0.037); at valgus, the internal rotation angle was also decreased significantly at knee flexion of 60° (p = 0.013), 90° (p = 0.045). Comparing to Group A, only the internal rotation angle (p = 0.047) and anterior displacement (p = 0.033) in Group C were increased at knee flexion of 30°.Conclusion: In simulated knee with intact ACL, LMPRT can still lead to the notable internal rotational instability at knee flexion from 30° to 90°, as well as the anterior shift instability at knee flexion from 30° to 60°. LMPRT repair help to improve the internal rotation stability at 30° and restore it at 60° to 90°, and improve the anterior shift stability at 30° and restore it at 60°.
Collapse
Affiliation(s)
- Yan-Song Qi
- Department of Orthopedics, Inner Mongolia People’s Hospital, Hohhot, China
| | - Hu-Ri-Cha Bao
- Department of Orthopedics, Inner Mongolia People’s Hospital, Hohhot, China
| | - Li-Yuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Pei-Liang Gu
- Department of Histology and Embryology, School of Basic Medical Science, Peking University Health Science Center, Beijing, China
| | - Chao-Le-Men Kong
- Department of Orthopedics, Inner Mongolia People’s Hospital, Hohhot, China
| | - Jun-Chen Wang
- School of Mechanical Engineering and Automation, Beihang University, Beijing, China
- *Correspondence: Jun-Chen Wang, ; Yong-Sheng Xu,
| | - Yong-Sheng Xu
- Department of Orthopedics, Inner Mongolia People’s Hospital, Hohhot, China
- *Correspondence: Jun-Chen Wang, ; Yong-Sheng Xu,
| |
Collapse
|
5
|
Lateral Meniscus Posterior Root Injury: MRI Findings in Children With Anterior Cruciate Ligament Tear. AJR Am J Roentgenol 2021; 217:984-994. [PMID: 33728972 DOI: 10.2214/ajr.21.25554] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND. Undiagnosed and unrepaired root tears are increasingly recognized as a preventable cause of accelerated osteoarthritis. Preoperative MRI findings of lateral meniscus posterior root tears in children with concomitant anterior cruciate ligament (ACL) injury are not well described. OBJECTIVE. The purpose of this study was to investigate the performance of preoperative MRI for identifying concomitant lateral meniscus posterior root injuries in pediatric patients with ACL tears with arthroscopy as the reference standard. METHODS. Consecutively registered children who underwent MRI within 90 days before arthroscopic primary ACL reconstruction between March 2017 and December 2019 were included. Two radiologists assessed MRI examinations for direct signs involving the root proper and for findings associated with lateral meniscus posterior root tears. Kappa coefficients for MRI findings were computed. Findings in patients with root tears and intact roots were compared by independent-samples t test, Mann-Whitney U test, chi-square test, Fisher exact test, and multivariable logistic regression analysis. RESULTS. At arthroscopy, 39 children (18 boys, 21 girls; mean age, 15.2 ± 1.4 years) had lateral meniscus posterior root tears; 51 (22 boys, 29 girls; mean age, 15.7 ± 1.8 years) had intact roots. Kappa coefficients ranged from 0.65 to 0.92, aside from tears involving the entheseal segment (κ = 0.55) or popliteomeniscal fascicles (κ = 0.45). MRI findings that were predictors of arthroscopically diagnosed root tear (p < .05) were lateral meniscus root tear in any segment (odds ratio [OR], 16.8; 95% CI, 5.6-50.1), degeneration in any segment (OR, 3.9; 95% CI, 1.6-9.6), coronal cleft sign (OR, 5.7; 95% CI, 2.0-16.7), sagittal ghost sign (OR, 4.8; 95% CI, 1.2-19.1), and axial radial defect sign (OR, 7.1; 95% CI, 2.4-20.5). Tear involving any segment of the root proper had the highest PPV, 82%, with 79% NPV. The coronal cleft, sagittal ghost, and axial radial defect signs had specificities of 88%, 94%, and 88% but sensitivities of 44%, 23%, and 49%. The only significant independent predictor on preoperative MRI was root tear in any segment (OR, 15.8; 95% CI, 2.7-137.5; p = .003). CONCLUSION. Among MRI findings evaluated for preoperative diagnosis of lateral meniscus posterior root tear, tear involving any segment of the root proper had the strongest performance; associated findings had high specificity but low sensitivity. CLINICAL IMPACT. Accurate identification of lateral meniscus posterior root tears on preoperative MRI can aid in operative planning and reduce treatment delay.
Collapse
|
6
|
Wang JY, Qi YS, Bao HRC, Xu YS, Wei BG, Wang YX, Ma BX, Zhou HW, Lv F. The effects of different repair methods for a posterior root tear of the lateral meniscus on the biomechanics of the knee: a finite element analysis. J Orthop Surg Res 2021; 16:296. [PMID: 33952275 PMCID: PMC8097866 DOI: 10.1186/s13018-021-02435-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/20/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To explore the impact of different repair methods for a lateral meniscus posterior root tear on the biomechanics of the knee joint using finite element analysis. METHODS Finite element models of a healthy knee were established on the basis of MRI data from a volunteer using Mimics software, and the validity of the models was tested. The changes in the contact mechanics and kinematics of these finite element models under different repair approaches were then analyzed and compared. RESULTS The normal meniscus had the maximum joint contact area, the minimum contact pressure, and the minimum contact stress. When total meniscectomy of the lateral meniscus was performed, the lateral compartment had the minimum joint contact area, the maximum contact pressure and the maximum contact stress. When complete avulsions of the posterior root of the lateral meniscus occurred, the maximum values of contact pressure and contact stress were between those of an intact meniscus and those of a meniscus treated with total meniscectomy. Lateral meniscal root attachment reconstruction by the single-stitch and double-stitch techniques resulted in a significant decrease in joint contact pressure and contact stress, leading to values comparable to those of a normal knee joint, and the double-stitch technique performed better than the single-stitch technique. CONCLUSIONS Repair surgery for lateral meniscal posterior root avulsions can effectively restore the contact mechanics and kinematics of the knee joint, and the double-stitch technique can result in better clinical outcomes than the single-stitch technique.
Collapse
Affiliation(s)
- Jian-Yu Wang
- Department of Orthopedics, Inner Mongolia People's Hospital, No.20 Zhao Wu Da Street, Hohhot, 010017, Inner Mongolia Autonomous Region, China
- Graduate School of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, China
| | - Yan-Song Qi
- Department of Orthopedics, Inner Mongolia People's Hospital, No.20 Zhao Wu Da Street, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Hu-Ri-Cha Bao
- Department of Orthopedics, Inner Mongolia People's Hospital, No.20 Zhao Wu Da Street, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Yong-Sheng Xu
- Department of Orthopedics, Inner Mongolia People's Hospital, No.20 Zhao Wu Da Street, Hohhot, 010017, Inner Mongolia Autonomous Region, China.
| | - Bao-Gang Wei
- Department of Orthopedics, Inner Mongolia People's Hospital, No.20 Zhao Wu Da Street, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Yong-Xiang Wang
- Department of Orthopedics, Inner Mongolia People's Hospital, No.20 Zhao Wu Da Street, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Bing-Xian Ma
- Department of Orthopedics, Inner Mongolia People's Hospital, No.20 Zhao Wu Da Street, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Hui-Wen Zhou
- Department of Orthopedics, Inner Mongolia People's Hospital, No.20 Zhao Wu Da Street, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| | - Fei Lv
- Department of Orthopedics, Inner Mongolia People's Hospital, No.20 Zhao Wu Da Street, Hohhot, 010017, Inner Mongolia Autonomous Region, China
| |
Collapse
|
7
|
Magnetic resonance imaging of the meniscal roots. Skeletal Radiol 2020; 49:661-676. [PMID: 31915856 DOI: 10.1007/s00256-020-03374-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/30/2019] [Accepted: 01/02/2020] [Indexed: 02/02/2023]
Abstract
The meniscal roots and supporting structures anchor the menisci to the tibial plateau and resist hoop stress, thereby preventing radial displacement of the menisci and secondary degenerative tibiofemoral compartment changes that may occur if this is compromised. The anatomy of the four meniscal roots and their supporting structures on magnetic resonance imaging (MRI) will be outlined in this review article, as well as the imaging appearances of meniscal root-related pathology, namely meniscal root degeneration and tears, meniscal extrusion and tibial plateau cystic lesions.
Collapse
|
8
|
Wang P, Zhang CZ, Zhang D, Liu QY, Zhong XF, Yin ZJ, Wang B. The imaging features of the meniscal roots on isotropic 3D MRI in young asymptomatic volunteers. Medicine (Baltimore) 2018; 97:e0624. [PMID: 29718873 PMCID: PMC6392791 DOI: 10.1097/md.0000000000010624] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND This study aimed to describe clearly the normal imaging features of the meniscal roots on the magnetic resonance imaging (MRI) with a 3-dimensional (3D) proton density-weighted (PDW) sequence at 3T. METHODS A total of 60 knees of 31 young asymptomatic volunteers were examined using a 3D MRI. The insertion patterns, constitution patterns, and MR signals of the meniscal roots were recorded. RESULTS The anterior root of the medial meniscus (ARMM), the anterior root of the lateral meniscus (ARLM), and the posterior root of the medial meniscus (PRMM) had 1 insertion site, whereas the posterior root of the lateral meniscus (PRLM) can be divided into major and minor insertion sites. The ARLM and the PRMM usually consisted of multiple fiber bundles (≥3), whereas the ARMM and the PRLM often consisted of a single fiber bundle. The ARMM and the PRLM usually appeared as hypointense, whereas the ARLM and the PRMM typically exhibited mixed signals. CONCLUSIONS The meniscal roots can be complex and diverse, and certain characteristics of them were observed on 3D MRI. Understanding the normal imaging features of the meniscal roots is extremely beneficial for further diagnosis of root tears.
Collapse
Affiliation(s)
- Ping Wang
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University, School of Medicine, Binzhou Medical University, Binzhou
| | - Cheng-Zhou Zhang
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University, School of Medicine, Binzhou Medical University, Binzhou
| | - Di Zhang
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University, School of Medicine, Binzhou Medical University, Binzhou
| | - Quan-Yuan Liu
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University, School of Medicine, Binzhou Medical University, Binzhou
| | - Xiao-Fei Zhong
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University, School of Medicine, Binzhou Medical University, Binzhou
| | - Zhi-Jie Yin
- Department of Radiology, The Affiliated Hospital of Binzhou Medical University, School of Medicine, Binzhou Medical University, Binzhou
| | - Bin Wang
- Medical Imaging Research Institute, Department of Radiology, School of Medicine, Binzhou Medical University, Yantai, Shandong, China
| |
Collapse
|
9
|
Choi NH, Yang BS, Lee SY, Lee CC, Lee CY, Victoroff BN. Comparison of the insertion of the posterior horn of the lateral meniscus: discoid versus non-discoid. Knee Surg Sports Traumatol Arthrosc 2017; 25:397-402. [PMID: 27177640 DOI: 10.1007/s00167-016-4161-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/22/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to compare the insertion sites of the posterior horn between discoid and non-discoid lateral meniscus using magnetic resonance imaging (MRI). METHODS Two hundred and twenty-seven patients who had MRI scans before surgery and underwent arthroscopy were enroled in this study. A coronal view showing the narrowest width of the midbody of the lateral meniscus was chosen to measure the widths of the entire tibial plateau and the midbody of the lateral meniscus. Considering the ratio of the meniscal width to the tibial plateau width, the patients were divided into non-discoid, incomplete discoid, and complete discoid groups. On a coronal view accurately showing the insertion of the posterior horn of the lateral meniscus, a distance between the peak of the lateral tibial eminence and the centre of the insertion of the posterior horn, and a width of the lateral tibial plateau between the lateral edge of the tibial plateau and the peak of the lateral tibial eminence were measured. RESULTS The insertion centre of the posterior horn was located more medially in the incomplete and complete discoid groups than in the non-discoid group (p = 0.003, 0.010, respectively). When individual differences in the knee size were corrected, the insertion centre of the posterior horn in the incomplete discoid and complete discoid groups was located more medially than in the non-discoid group (p = 0.009, 0.003, respectively). CONCLUSION The insertion centre of the posterior horn of the lateral meniscus is located more medially to the apex of the lateral tibial eminence in the discoid group than in the non-discoid group. This finding needs to be considered for an accurate position of the posterior horn of lateral meniscus during the lateral meniscal allograft transplantation. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Nam-Hong Choi
- Department of Orthopaedic Surgery, Eulji Medical Center, 68, Hangeulbiseok-ro, Nowon-gu, Seoul, 01830, Korea
| | - Bong-Seok Yang
- Department of Orthopaedic Surgery, Gwangmyeong Sungae Hospital, 36, Digital-ro, Gwangmyeong, 14241, Korea.
| | - Sang-Young Lee
- Department of Orthopaedic Surgery, Eulji Medical Center, 68, Hangeulbiseok-ro, Nowon-gu, Seoul, 01830, Korea
| | - Chae-Chul Lee
- Department of Orthopaedic Surgery, Gwangmyeong Sungae Hospital, 36, Digital-ro, Gwangmyeong, 14241, Korea
| | - Chang-Yk Lee
- Department of Orthopaedic Surgery, Gwangmyeong Sungae Hospital, 36, Digital-ro, Gwangmyeong, 14241, Korea
| | - Brian N Victoroff
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
10
|
Strauss EJ, Day MS, Ryan M, Jazrawi L. Evaluation, Treatment, and Outcomes of Meniscal Root Tears. JBJS Rev 2016; 4:01874474-201608000-00004. [DOI: 10.2106/jbjs.rvw.15.00082] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
11
|
Vassiou K, Vlychou M, Zibis A, Nikolopoulou A, Fezoulidis I, Arvanitis D. Synovial plicae of the knee joint: the role of advanced MRI. Postgrad Med J 2014; 91:35-40. [PMID: 25476020 DOI: 10.1136/postgradmedj-2013-132176] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Synovial plicae are normal anatomical structures of the knee that may become symptomatic. MRI is an established technique for evaluating the anatomy of the knee, and it is a valuable tool for detecting plicae because of its high resolution resulting in increased tissue characterisation. At MRI, knee plicae appear as low-signal-intensity structures of variable size and thickness, and they are better visualised at fluid-sensitive sequences with or without fat suppression. The combined use of clinical examination and MRI may also facilitate the diagnosis of fibrotic or inflamed plicae that may be symptomatic. Arthroscopy remains the gold standard for recognition and repair of knee plicae in cases of knee dysfunction.
Collapse
Affiliation(s)
- Katerina Vassiou
- Department of Anatomy, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Marianna Vlychou
- Department of Radiology, University of Thessaly, Larissa, Greece
| | - Aristidis Zibis
- Department of Anatomy, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Athina Nikolopoulou
- Department of Anatomy, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | | | - Dimitrios Arvanitis
- Department of Anatomy, Faculty of Medicine, University of Thessaly, Larissa, Greece
| |
Collapse
|
12
|
Chang EY, Biswas R, DiCamillo P, Statum S, Tafur M, Bydder GM, Chung CB. Morphologic characterization of meniscal root ligaments in the human knee with magnetic resonance microscopy at 11.7 and 3 T. Skeletal Radiol 2014; 43:1395-402. [PMID: 24957332 DOI: 10.1007/s00256-014-1941-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 06/02/2014] [Accepted: 06/04/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the feasibility of using MR microscopy to characterize the root ligaments of the human knee at both ultra-high-field (11.7 T) and high-field (3 T) strengths. MATERIALS AND METHODS Seven fresh cadaveric knees were used for this study. Six specimens were imaged at 11.7 T and one specimen at 3 T using isotropic or near-isotropic voxels. Histologic correlation was performed on the posteromedial root ligament of one specimen. Meniscal root ligament shape, signal intensity, and ultrastructure were characterized. RESULTS High-resolution, high-contrast volumetric images were generated from both MR systems. Meniscal root ligaments were predominantly oval in shape. Increased signal intensity was most evident at the posteromedial and posterolateral root ligaments. On the specimen that underwent histologic preparation, increased signal intensity corresponded to regions of enthesis fibrocartilage. Collagen fascicles were continuous between the menisci and root ligaments. Predominantly horizontal meniscal radial tie fibers continued into the root ligaments as vertical endoligaments. CONCLUSION MR microscopy can be used to characterize and delineate the distinct ultrastructure of the root ligaments on both ultra-high-field- and high-field-strength MR systems.
Collapse
Affiliation(s)
- Eric Y Chang
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, 92161, USA,
| | | | | | | | | | | | | |
Collapse
|