In vitro study of contact area and pressure distribution in the human knee after partial and total meniscectomy
Tóm tắt
Many investigators have attempted to find the cause of the osteoarthritic changes after meniscectomy. Alteration of the mechanical factors resulting in stress concentration, is now thought to be one of the most important causes but few experimental studies have reported the differences in contact area and pressure distribution after partial or total meniscectomy. By using pressure sensitive film, we have calculated the contact area and the pattern of weight distribution in three different situations; intact meniscus, partial and total meniscectomy. The experimental materials were obtained from 5 above knee amputation specimens. The knee joint was fixed in full extension to an Instron machine using an aluminium box and mounting resin. Load was transmitted to the tibiofemoral joint containing the special film, within a physiological range. Analysis of the contact area for each situation (intact meniscus, partial and total meniscectomy) was made by reviewing the film, By measuring the contact area after meniscectomy, we showed that the meniscus performs a load transmitting function in the knee joint. The medial contact area of the tibiofemoral joint with an intact meniscus is always larger than the lateral compartment (1.36:1), but in partial and total meniscectomy the difference between them gradually decreased. There was a minor decrease in contact area after partial meniscectomy and a much greater decrease after total meniscectomy. The degree of stress concentration in the contact area was increased when part or all the meniscus was excised. There was little change of contact area in the opposite, intact side of the joint after partial meniscectomy, but marked change after total meniscectomy.
Tài liệu tham khảo
Allen PR, Denham RA, Swan AV (1984) Late degenerative changes after meniscectomy. J Bone Joint Surg [Br]: 666–671
Baratz ME, Rehak DC, Fu FH, Rudert MJ (1988) Peripheral tears of the meniscus. Am J Sports Med 16: 1–6
Berjon JJ, Munuera L, Calvo M (1991) Degenerative lesions in the articular cartilage after meniscectomy: preliminary experimental study in dogs. J Trauma 31: 343–350
Cox JC, Ney CE, Schaefer WW, Woodstein IJ (1975) The degenerative effects of partial and total resection of medial meniscus in dog's knee. Clin Orthop 109: 178–183
Fairbank TJ (1948) Knee joint changes after meniscectomy. J Bone Joint Surg [Br] 30: 664–670
Ihn JC, Ahn MW, Kim DM (1989) Stress distribution on the tibio-femoral joint after meniscectomy. J Korean Orthop 24: 1553–1564
Johnson RJ, Kettelkamp DB, Clark W, Leaverton P (1974) Factors affecting late results after meniscectomy. J Bone Joint Surg [Am] 56: 719–729
Kettelkamp DB, Jacobs AW (1972) Tibiofemoral contact area determination and implications. J Bone Joint Surg [Am] 54: 349–356
King D (1936) The function of semilunar cartilage. J Bone Joint Surg [Am] 18: 1069–1076
Krause WR, Pope MH, Johnson RJ, Wilder DG (1976) Mechanical changes after meniscectomy. J Bone Joint Surg [Am] 58: 599–604
Lim HC, Lee SH, Shon WY, Lee DW, Na KW (1991) A X-ray and clinical study upon knee joint changes following surgical removal of discoid meniscus. J Korean Orthop 26: 41–48
Maquet PG, Van De Berg AJ, Simonet JC (1975) Femorotibial weight bearing area. J Bone Joint Surg [Am] 57: 766–771
Rudert MM, Baratz ME, Rehak DC, Fu FH (1988) Loading characteristics of pressensor. Transaction of the 34th Annual Meeting. Orthop Res Soc 1: 226–227
Seedhom (1979) Transmission of the load in the knee joint with special reference to the role of the menisci. Eng Med Imeche, vol B: 207–228
Smillie IS (1944) Observation on the regeneration of the semilunar cartilage in man. Br J Surg 31: 398–401
Tapper EM, Hoover NW (1969) Late results after meniscectomy. J Bone Joint Surg [Am] 51: 517–526
Walker PS, Hajek JV (1972) The load-bearing area in the knee joint. J Biomech 5: 581–589