Khalis Boksh, Duncan E T Shepherd, Daniel M Espino, Christos Plakogiannis, Arijit Ghosh, Randeep Aujla, Michael E Hantes, Tarek Boutefnouchet
{"title":"一项体外生物力学研究：单根修复和集中隧道可以最好地恢复内侧半月板后根撕裂后的胫股接触力学和挤压。","authors":"Khalis Boksh, Duncan E T Shepherd, Daniel M Espino, Christos Plakogiannis, Arijit Ghosh, Randeep Aujla, Michael E Hantes, Tarek Boutefnouchet","doi":"10.1002/ksa.12683","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate what tunnel combination, with respect to anatomical transtibial pull-through root repair (ATPR) and transtibial centralisation (TTC), best restores tibiofemoral contact mechanics and meniscal extrusion following a medial meniscus posterior root tear (MMPRT).</p><p><strong>Methods: </strong>Meniscal extrusion and contact mechanics were measured using two-dimensional imaging and pressure films in 10 porcine knee joints. The posterior root was tested under six states: (1) intact; (2) MMPRT; (3) one tunnel ATPR and one tunnel TTC (1-ATPR + 1-TTC); (4) two tunnel ATPR and one tunnel TTC (2-ATPR + 1-TTC); (5) 1-ATPR + 2-TTC; and (6) 2-ATPR + 2-TTC. The testing protocol loaded knees with 200-N axial compression at 4 flexion angles (30°, 45°, 60° and 90°). At each angle and state, meniscal extrusion was measured as the difference in its position under load to that of the unloaded condition in the intact state. Contact area and pressure were recorded for all states at all angles and were analysed using a MATLAB programme.</p><p><strong>Results: </strong>MME was significantly reduced with both the 1-ATPR + 2-TTC and 2-ATPR + 2-TTC tunnels in comparison to the 1-ATPR + 1-TTC and 2-ATPR + 1-TTC tunnels at 60° and 90° (p < 0.05). The intact meniscus and 1-ATPR + 1-TTC technique had higher contact area at 60° (p = 0.01 and 0.04, respectively) and lower contact pressure at 90° (p = 0.01 and 0.04, respectively) compared to the 2-ATPR + 2-TTC technique. Otherwise, all tunnel combinations were similar to one another for contact mechanics and restored the loading profile to that of an intact meniscus (p > 0.05).</p><p><strong>Conclusion: </strong>When there are concerns of extrusion following a MMPRT, a combination of one centralisation and one root repair tunnel may provide better biomechanical properties compared to the addition of extra tunnels.</p><p><strong>Level of evidence: </strong>Not applicable (laboratory study).</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A single root repair and centralisation tunnel best restores tibiofemoral contact mechanics and extrusion following a medial meniscus posterior root tear: An in vitro biomechanical study.\",\"authors\":\"Khalis Boksh, Duncan E T Shepherd, Daniel M Espino, Christos Plakogiannis, Arijit Ghosh, Randeep Aujla, Michael E Hantes, Tarek Boutefnouchet\",\"doi\":\"10.1002/ksa.12683\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate what tunnel combination, with respect to anatomical transtibial pull-through root repair (ATPR) and transtibial centralisation (TTC), best restores tibiofemoral contact mechanics and meniscal extrusion following a medial meniscus posterior root tear (MMPRT).</p><p><strong>Methods: </strong>Meniscal extrusion and contact mechanics were measured using two-dimensional imaging and pressure films in 10 porcine knee joints. The posterior root was tested under six states: (1) intact; (2) MMPRT; (3) one tunnel ATPR and one tunnel TTC (1-ATPR + 1-TTC); (4) two tunnel ATPR and one tunnel TTC (2-ATPR + 1-TTC); (5) 1-ATPR + 2-TTC; and (6) 2-ATPR + 2-TTC. The testing protocol loaded knees with 200-N axial compression at 4 flexion angles (30°, 45°, 60° and 90°). At each angle and state, meniscal extrusion was measured as the difference in its position under load to that of the unloaded condition in the intact state. Contact area and pressure were recorded for all states at all angles and were analysed using a MATLAB programme.</p><p><strong>Results: </strong>MME was significantly reduced with both the 1-ATPR + 2-TTC and 2-ATPR + 2-TTC tunnels in comparison to the 1-ATPR + 1-TTC and 2-ATPR + 1-TTC tunnels at 60° and 90° (p < 0.05). The intact meniscus and 1-ATPR + 1-TTC technique had higher contact area at 60° (p = 0.01 and 0.04, respectively) and lower contact pressure at 90° (p = 0.01 and 0.04, respectively) compared to the 2-ATPR + 2-TTC technique. Otherwise, all tunnel combinations were similar to one another for contact mechanics and restored the loading profile to that of an intact meniscus (p > 0.05).</p><p><strong>Conclusion: </strong>When there are concerns of extrusion following a MMPRT, a combination of one centralisation and one root repair tunnel may provide better biomechanical properties compared to the addition of extra tunnels.</p><p><strong>Level of evidence: </strong>Not applicable (laboratory study).</p>\",\"PeriodicalId\":17880,\"journal\":{\"name\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-04-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Knee Surgery, Sports Traumatology, Arthroscopy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12683\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12683","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
A single root repair and centralisation tunnel best restores tibiofemoral contact mechanics and extrusion following a medial meniscus posterior root tear: An in vitro biomechanical study.
Purpose: To evaluate what tunnel combination, with respect to anatomical transtibial pull-through root repair (ATPR) and transtibial centralisation (TTC), best restores tibiofemoral contact mechanics and meniscal extrusion following a medial meniscus posterior root tear (MMPRT).
Methods: Meniscal extrusion and contact mechanics were measured using two-dimensional imaging and pressure films in 10 porcine knee joints. The posterior root was tested under six states: (1) intact; (2) MMPRT; (3) one tunnel ATPR and one tunnel TTC (1-ATPR + 1-TTC); (4) two tunnel ATPR and one tunnel TTC (2-ATPR + 1-TTC); (5) 1-ATPR + 2-TTC; and (6) 2-ATPR + 2-TTC. The testing protocol loaded knees with 200-N axial compression at 4 flexion angles (30°, 45°, 60° and 90°). At each angle and state, meniscal extrusion was measured as the difference in its position under load to that of the unloaded condition in the intact state. Contact area and pressure were recorded for all states at all angles and were analysed using a MATLAB programme.
Results: MME was significantly reduced with both the 1-ATPR + 2-TTC and 2-ATPR + 2-TTC tunnels in comparison to the 1-ATPR + 1-TTC and 2-ATPR + 1-TTC tunnels at 60° and 90° (p < 0.05). The intact meniscus and 1-ATPR + 1-TTC technique had higher contact area at 60° (p = 0.01 and 0.04, respectively) and lower contact pressure at 90° (p = 0.01 and 0.04, respectively) compared to the 2-ATPR + 2-TTC technique. Otherwise, all tunnel combinations were similar to one another for contact mechanics and restored the loading profile to that of an intact meniscus (p > 0.05).
Conclusion: When there are concerns of extrusion following a MMPRT, a combination of one centralisation and one root repair tunnel may provide better biomechanical properties compared to the addition of extra tunnels.
Level of evidence: Not applicable (laboratory study).
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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