Abstract
Purpose
Injury or degeneration of the meniscus has been associated with the development of osteoarthritis of the knee joint. Meniscal allograft transplant (MAT) has been shown to reduce pain and restore function in patients who remain symptomatic following meniscectomy. The purpose of this study is to evaluate and compare the three-dimensional (3D) strain in native medial menisci compared to allograft-transplanted medial menisci in both the loaded and unloaded states.
Methods
Ten human cadaveric knees underwent medial MAT, utilizing soft-tissue anterior and posterior root fixation via transosseous sutures tied over an anterolateral proximal tibial cortical bone bridge. The joint was imaged first in the non-loaded state, then was positioned at 5° of flexion and loaded to 1× body weight (650 ± 160 N) during MR image acquisition. Anatomical landmarks were chosen from each image to create a tibial coordinate system, which were then input into a custom-written program (Matlab R2014a) to calculate the 3D strain from the unloaded and loaded marker positions. Six independent strains were obtained: three principal strains and three shearing strains.
Results
No statistically significant difference was found between the middle and posterior strains in the native knee compared to the meniscus allograft. This would suggest that soft-tissue fixation of meniscal allografts results in similar time zero principal and shear strains in comparison to the native meniscus.
Conclusion
These results suggest that time zero MAT performs in a similar manner to the native meniscus. Optimizing MAT strain behavior may lead to potential improvements in its chondroprotective effect.
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References
Abat F, Gelber PE, Erquicia JI, Pelfort X, Gonzalez-Lucena G, Monllau JC (2012) Suture-only fixation technique leads to a higher degree of extrusion than bony fixation in meniscal allograft transplantation. Am J Sports Med 40:1591–1596
Abat F, Gelber PE, Erquicia JI, Tey M, Gonzalez-Lucena G, Monllau JC (2013) Prospective comparative study between two different fixation techniques in meniscal allograft transplantation. Knee Surg Sports Traumatol Arthrosc 21:1516–1522
Alentorn-Geli E, Seijas Vazquez R, Garcia Balletbo M, Alvarez Diaz P, Steinbacher G, Cusco Segarra X, Rius Vilarrubia M, Cugat Bertomeu R (2011) Arthroscopic meniscal allograft transplantation without bone plugs. Knee Surg Sports Traumatol Arthrosc 19:174–182
Chen L, Gordon K, Hurtig M (2014) Design and validation of a cadaveric knee joint loading device compatible with magnetic resonance imaging and computed tomography. Med Eng Phys 36:1346–1351
De Coninck T, Huysse W, Verdonk R, Verstraete K, Verdonk P (2013) Open versus arthroscopic meniscus allograft transplantation: magnetic resonance imaging study of meniscal radial displacement. Arthroscopy 29:514–521
Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Jt Surg Br 30B:664–670
Gonzalez-Lucena G, Gelber PE, Pelfort X, Tey M, Monllau JC (2010) Meniscal allograft transplantation without bone blocks: a 5- to 8-year follow-up of 33 patients. Arthroscopy 26:1633–1640
Ha JK, Shim JC, Kim DW, Lee YS, Ra HJ, Kim JG (2010) Relationship between meniscal extrusion and various clinical findings after meniscus allograft transplantation. Am J Sports Med 38:2448–2455
Hergan D, Thut D, Sherman O, Day MS (2011) Meniscal allograft transplantation. Arthroscopy 27:101–112
Jones A, Sealey R, Crowe M, Gordon S (2014) Concurrent validity and reliability of the simple goniometer iPhone app compared with the universal goniometer. Physiother Theory Pract 30:512–516
Kolaczek S, Hewison C, Caterine S, Ragbar MX, Getgood A, Gordon KD (2016) Analysis of 3D strain in the human medial meniscus. J Mech Behav Biomed Mater 63:470–475
Lee BS, Kim JM, Kim JM, Kim KA, Bin SI (2015) Patient-related risk factors for the extrusion of lateral meniscal allograft transplants. Arthroscopy 31:699–706
Lubowitz JH, Verdonk PC, Reid JB 3rd, Verdonk R (2007) Meniscus allograft transplantation: a current concepts review. Knee Surg Sports Traumatol Arthrosc 15:476–492
Makris EA, Hadidi P, Athanasiou KA (2011) The knee meniscus: structure-function, pathophysiology, current repair techniques, and prospects for regeneration. Biomaterials 32:7411–7431
Marcacci M, Zaffagnini S, Marcheggiani Muccioli GM, Grassi A, Bonanzinga T, Nitri M, Bondi A, Molinari M, Rimondi E (2012) Meniscal allograft transplantation without bone plugs: a 3-year minimum follow-up study. Am J Sports Med 40:395–403
McDermott ID, Lie DT, Edwards A, Bull AM, Amis AA (2008) The effects of lateral meniscal allograft transplantation techniques on tibio-femoral contact pressures. Knee Surg Sports Traumatol Arthrosc 16:553–560
Myers P, Tudor F (2015) Meniscal allograft transplantation: how should we be doing it? A systematic review. Arthroscopy 31:911–925
Oh KJ, Sobti AS, Yoon JR, Ko YB (2015) Current status of second-look arthroscopy after meniscal allograft transplantation: review of the literature. Arch Orthop Trauma Surg 135:1411–1418
Pollard ME, Kang Q, Berg EE (1995) Radiographic sizing for meniscal transplantation. Arthroscopy 11:684–687
Samitier G, Alentorn-Geli E, Taylor DC, Rill B, Lock T, Moutzouros V, Kolowich P (2015) Meniscal allograft transplantation. Part 2: systematic review of transplant timing, outcomes, return to competition, associated procedures, and prevention of osteoarthritis. Knee Surg Sports Traumatol Arthrosc 23:323–333
Smith NA, Parkinson B, Hutchinson CE, Costa ML, Spalding T (2015) Is meniscal allograft transplantation chondroprotective? A systematic review of radiological outcomes. Knee Surg Sports Traumatol Arthrosc 24:2923–2935
Waldman LK, Fung YC, Covell JW (1985) Transmural myocardial deformation in the canine left ventricle. Normal in vivo three-dimensional finite strains. Circ Res 57:152–163
Acknowledgements
This study was supported by a research grant from the Musculoskeletal Transplant Foundation.
Funding
This study was funded by a research grant from the Musculoskeletal Transplant Foundation (MTF).
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Kolaczek, S., Hewison, C., Caterine, S. et al. 3D strain in native medial meniscus is comparable to medial meniscus allograft transplant. Knee Surg Sports Traumatol Arthrosc 27, 349–353 (2019). https://doi.org/10.1007/s00167-018-5075-3
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DOI: https://doi.org/10.1007/s00167-018-5075-3