Document Title: Hollis-AJSM-Sep00

Article Title: Charge in meniscal strain with anterior cruciate ligament injury and after reconstruction

Author: J. Marcus Hollis, Albert W. Pearsall IV, Peter G. Niciforos;

Publication: The American Journal of Sports Medicine

ISSN: 03635465

Date: September-October 2000.

(Figures included. Reference-denoting numbers appear in the same point size as document text.)

Volume: 28

Issue: 5

Pages: 700-704

Key Words: Knee, ligaments, menisci, articular, cartilage.

This article points out the importance of reliable and stable knee functioning to long-term meniscal integrity. Hollis makes it clear that in an unstable ACL-deficient knee, the menisci are at risk of tearing (or further tearing, if they have already incurred damage in conjunction with the ACL injury). Meniscal loss is well-correlated with articular-cartilage wearing; hence the imperative behind making every effort to preserve every ounce of meniscal tissue. (The menisci are responsible for absorbing shock, as well as distributing compressive and shear forces over the vulnerable bone-covering articular cartilage. The menisci also assist the synovial fluid in lubricating the joint, and contribute to overall knee stability. Regrettably, the central portions, which happen to be avascular and thus dependent upon diffusion for nutrient-supply purposes, are the most essential to articular cartilage longevity. Because these areas are also those which are most difficult to repair surgically, they are most likely to be excised. Note that even a 25% loss of a meniscus can result in a quadrupling of stress on the articular cartilage. Keep in mind that the knee is biomechanically the most-highly-stressed joint in the entire body, owing to the unique combination of enormous dynamic loadings it must contend with daily, the wrenching action of the long lever arms of the leg bones, and a complete lack of native bony stability. Chronic ACL deficiency is a well-known harbinger of osteoarthritis; by the time the chronically-ACLless person feels arthritic pain in the knee, the problem has often already progressed to the stage of irreversibility.)

ABSTRACT

Meniscal injury has been well documented in association with injury to the anterior cruciate ligament. The purpose of this study was to evaluate the effect of anterior cruciate ligament transection and reconstruction on meniscal strain. Four differential variable reluctance transducer strain gauges were placed in the medial and lateral menisci of nine cadaveric knees. Each specimen was mounted to a six-degree-of-freedom knee testing device. Testing was conducted with the knee fully extended and at 45 deg and 90 deg of flexion, both with and without applied axial load. At each angle of flexion, an anterior and posterior tibial load was applied. Next, the anterior cruciate ligament was transected and the testing sequence was repeated. Finally, the ligament was reconstructed using a central one-third patellar tendon graft and the testing sequence was repeated. The results demonstrated statistically significant increases in meniscal strain in ligament-transected knees compared with intact specimens. A reduction in meniscal strain to a level similar to that detected in the ligament-intact knees was observed after anterior cruciate ligament reconstruction. These results have important clinical implications regarding the potentially deleterious effect of the anterior cruciate ligament-deficient knee on meniscal strain and the potential benefit of anterior cruciate ligament reconstruction.

To access the full text of this article, please click here.
There is no charge for viewing articles. However, a password is required.
If you do not already have a password, please e-mail Michael Frind at frind@execulink.com for one.
Prior to requesting a password, please make certain you have read the Site Terms of Use pertaining to this site.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Copyright American Journal of Sports Medicine Sep/Oct 2000.  For details regarding copyright as it applies to this page, please visit the page entitled "Site Terms of Use and Aspects of Copyright" on this site.

This website was created for the benefit of the world's largest knee-injury community, Bob's ACL WWWBoard, accessible to everyone at http://factotem.org.

Documents posted on this site serve merely as a virtual library, and are intended solely for purposes of making access to high-quality peer-reviewed medical journals convenient for everyone.  Knee-injury patients are hereby encouraged to discuss this material with their respective medical teams.