Partial Lateral Meniscectomy Affects Knee Stability Even in Anterior Cruciate Ligament-Intact Knees

• Published in: Journal of bone and joint surgery. American volume 2020-04, Vol.102 (7), p.567-573
• Main Authors: Novaretti, João V., Lian, Jayson, Patel, Neel K., Chan, Calvin K., Cohen, Moises, Musahl, Volker, Debski, Richard E.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anterior Cruciate Ligament; Biomechanical Phenomena; Cadaver; Humans; Joint Instability - etiology; Joint Instability - physiopathology; Knee Joint; Meniscectomy - adverse effects; Meniscectomy - methods; Middle Aged
• ISSN: 0021-9355; 1535-1386
• DOI: 10.2106/JBJS.19.00712

BACKGROUND:The effects of a partial lateral meniscectomy on knee kinematics and forces in the lateral meniscus are critical to understand. The purpose of this study was to quantify the effects of varying sizes of partial lateral meniscectomies of the posterior horn and a total lateral meniscectomy on knee kinematics and resultant forces in the lateral meniscus. METHODS:Using a robotic testing system, loads (134-N anterior tibial load + 200-N axial compression, 5-Nm internal tibial torque + 5-Nm valgus torque, and 5-Nm external tibial torque + 5-Nm valgus torque) were applied to 10 fresh-frozen cadaveric knees. The resulting joint motion and resultant forces in the lateral meniscus were determined for 4 knee statesintact, one-third and two-thirds partial lateral meniscectomies of the posterior horn, and total lateral meniscectomy. RESULTS:A decrease in lateral translation of the tibia (up to 166.7%) was observed after one-third partial lateral meniscectomies of the posterior horn compared with the intact knee, in response to an anterior load at all knee flexion angles tested (p < 0.05). One-third partial lateral meniscectomies of the posterior horn decreased the resultant forces in the lateral meniscus compared with the intact knee at all knee flexion angles tested in response to an anterior load (p < 0.05) and to an internal tibial torque (p < 0.05). The results of two-thirds partial lateral meniscectomies of the posterior horn were similar to those of one-third partial meniscectomies (p > 0.05). Total lateral meniscectomies further decreased the lateral translation of the tibia (up to 316.6%) compared with the intact knee in response to an anterior load (p < 0.05). CONCLUSIONS:The changes in joint motion and meniscal forces observed in this study after even small partial lateral meniscectomies may predispose knees to further injury. CLINICAL RELEVANCE:Surgeons should always consider repairing and minimizing the resection of even small lateral meniscal tears to prevent the potential deleterious effects of partial meniscectomy reported in this cadaveric study.