The Biomechanical Study On Different Meniscal Repair And Partial Meniscectomy

ObjectiveOur purpose was to determine the ability of vertical, horizontal, and cruciate suture meniscal repairs to restore normal contact mechanics incanine sties with simulated bucket handle meniscal tears and to evaluate changes in femorotibial contact areas and pressures after serial meniscectomies of the caudal pole of the medial meniscus.MethodsSimulated bucket handle medial meniscal tears were created. Tears were treated with1of3suture repair techniques or partial meniscectomy. Instantaneous contact area (CA), mean contact pressure (MCP), and peak contact pressure (PCP) measurements were recorded with a pressure sensing system. CA, MCP, and PCP for intact stifles (control), stifles with simulated tears, and stifles after treatment were recorded and compared using1-way repeated measures ANOVA. Unpaired pelvic limbs from8adult dogs. All specimens underwent sequentially, a30%radial width partial meniscectomy, a75%radial width partial meniscectomy, and a segmental caudal pole hemi-meniscectomy. Digital pressure sensors were used to measure lateral and medial peak and mean contact pressures and areas before and after serial meniscectomies. Meniscal strain was measured under load in the intact meniscus and after30%and75%radial width meniscectomy.ResultsStifles with bucket handle tears had significantly decreased CA, increased MCP and increased PCP when compared with control. All meniscal repair techniques reestablished normal contact mechanics. When comparing meniscal repair and partial meniscectomy, stifles with partial meniscectomy had lower CA, higher MCP and PCP than stifles undergoing repair. A30%radial width meniscectomy had no significant effect on contact mechanics. A75%radial width caused a39.4%increase and hemi-meniscectomy an78.9%increase in peak contact pressures compared with control. Medial CA decreased by33.1%after75%radial width meniscectomy. A30%and a75%radial width meniscectomy resulted in decrease in medial meniscal strain compared with control,but these differences were not statistically significant. ConclusionsIn this cadaveric model, smaller(30%)partial meniscectomies had Minimal effect on the biomechanics of meniscal function, whereas larger partial (75%) and segmental meniscectomies resulted in significant changes in meniscal and femorotibial contact mechanics. Contact mechanics obtained from each repair technique were mechanically superior to partial meniscectomy. Performing meniscal repair instead of partial meniscectomy with select meniscal tears may mitigate the development of degenerative joint disease. Criteria for selection of candidates for meniscal repair should be confirmed in future studies.