Altered Tibiofemoral Contact Mechanics Due to Lateral Meniscus Posterior Horn Root Avulsions and Radial Tears Can Be Restored with in Situ Pull-Out Suture.

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Presentation transcript:

Altered Tibiofemoral Contact Mechanics Due to Lateral Meniscus Posterior Horn Root Avulsions and Radial Tears Can Be Restored with in Situ Pull-Out Suture Repairs by Christopher M. LaPrade, Kyle S. Jansson, Grant Dornan, Sean D. Smith, Coen A. Wijdicks, and Robert F. LaPrade J Bone Joint Surg Am Volume 96(6):471-479 March 19, 2014 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Representative pressure mapping demonstrating the contact area and pressure distribution in the lateral and medial compartments of specimen 7 (a left knee) at 30° of flexion for the eight lateral meniscus conditions. Representative pressure mapping demonstrating the contact area and pressure distribution in the lateral and medial compartments of specimen 7 (a left knee) at 30° of flexion for the eight lateral meniscus conditions. The diamond shows that the distribution of pressure between the medial and lateral compartments of the knee was equal. Christopher M. LaPrade et al. J Bone Joint Surg Am 2014;96:471-479 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Location of the tears at the site of the posterior root attachment of the lateral meniscus of a right knee. Location of the tears at the site of the posterior root attachment of the lateral meniscus of a right knee. From left to right, the four tears are footprint tear, root avulsion, and radial tears at 3 and 6 mm. ACL = anterior cruciate ligament, PCL = posterior cruciate ligament, LTE = lateral tibial eminence, and MTE = medial tibial eminence. Christopher M. LaPrade et al. J Bone Joint Surg Am 2014;96:471-479 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Figs. 3-A and 3-B Schematic showing an in situ suture repair of the posterior root attachment of the lateral meniscus of a right knee. Figs. 3-A and 3-B Schematic showing an in situ suture repair of the posterior root attachment of the lateral meniscus of a right knee. ACL = anterior cruciate ligament, and PCL = posterior cruciate ligament. Fig. 3-A Posterior view showing a root avulsion. Fig. 3-B Anterior view showing how two horizontal mattress sutures were secured into the meniscus, pulled anteriorly with the use of an eyelet pin, and tied over a button on the anteromedial proximal aspect of the tibia. Christopher M. LaPrade et al. J Bone Joint Surg Am 2014;96:471-479 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Overall effect of each lateral meniscus condition on contact area in the lateral compartment when pooled across all flexion angles. Overall effect of each lateral meniscus condition on contact area in the lateral compartment when pooled across all flexion angles. The error bars indicate the standard error of the mean. *P < 0.05 compared with the intact condition. +P < 0.05 compared with the corresponding tear condition. Christopher M. LaPrade et al. J Bone Joint Surg Am 2014;96:471-479 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Overall effect of each lateral meniscus condition on mean contact pressure in the lateral compartment when pooled across all flexion angles. Overall effect of each lateral meniscus condition on mean contact pressure in the lateral compartment when pooled across all flexion angles. The error bars indicate the standard error of the mean. *P < 0.05 compared with the intact condition. +P < 0.05 compared with the corresponding tear condition. Christopher M. LaPrade et al. J Bone Joint Surg Am 2014;96:471-479 ©2014 by The Journal of Bone and Joint Surgery, Inc.

Overall effect of each lateral meniscus condition on peak contact pressure (as measured by any single sensel) in the lateral compartment when pooled across all flexion angles. Overall effect of each lateral meniscus condition on peak contact pressure (as measured by any single sensel) in the lateral compartment when pooled across all flexion angles. The error bars indicate the standard error of the mean. *P < 0.05 compared with the intact condition. +P < 0.05 compared with the corresponding tear condition. Christopher M. LaPrade et al. J Bone Joint Surg Am 2014;96:471-479 ©2014 by The Journal of Bone and Joint Surgery, Inc.