Summary: Lateral meniscus tears significantly impact in vivo knee kinematics, whereas for medial meniscus tears, no differences were observed in kinetics, and limited conflicting evidence for kinematics.

Introduction/Objective:
Extensive ex vivo evidence on the role of the meniscus in load transmission and knee stability has paved the way for the current point of emphasis on preserving the menisci. In contrast to the robust body of work stemming from cadaveric studies, there is a relative paucity of in vivo biomechanics studies on the matter. The primary aim of this study is to systematically review the effect of meniscal tears on in vivo kinematics and kinetics.

Methods

Databases were queried for level I-IV studies reporting baseline data meeting the following criteria: in vivo studies of gait or motion analysis; cohorts with isolated meniscal pathology; available kinematics and/or kinetics outcome measures. Demographic data, method of motion analysis employed, tasks performed, and measured outcomes were extracted and qualitatively appraised. Risk of bias assessment was conducted using the MINORS index. Standardized mean differences with a random effects model were calculated by comparing meniscal tear cohorts and healthy controls whenever allowed by homogeneous outcomes.

Results

Thirteen studies were eligible, with a pooled sample of 176 medial meniscal and 74 lateral meniscal tears. Eleven studies assessed gait, while different tasks such as lunge, step-down, and squatting were assessed in one study each. There was considerable variability in the outcomes, as well as in the method of motion analysis. In terms of gait kinematics relative to healthy control, there is qualitative evidence of increased lateral tibial translation in medial meniscal root pathology, and reduction in the variability of articular motion in medial bucket-handle tears. Meta-analysis revealed statistically significant decreases in peak knee flexion angle during stance (p=.0001) and swing (p<.0001), as well as in the range of adduction-abduction (p<.0001) and internal-external rotation (p<.0001) for the pooled sample of lateral meniscus tears. In terms of kinetics relative to healthy control, while there was qualitative evidence for unloading of the injured knee (decreased peak support moment, knee flexion, and extension moments), meta-analysis failed to demonstrate significant differences for peak knee flexion (p = 0.11) and peak knee adduction moments (p = 0.45). The mean MINORS index score for risk of bias was 19.0, ranging from 15 to 22 (out of a maximum possible score of 24).

Conclusion

There is high heterogeneity in terms of reported outcomes from motion analysis studies assessing isolated meniscus tears and largely limited to gait analysis. Qualitative evidence suggests kinetics changes reflecting mechanisms for unloading the injured joint, and that prior ex vivo findings of impaired knee kinematics from meniscal pathology translate to the in vivo setting. There is statistical evidence of limited sagittal, coronal, and axial plane kinematics for lateral meniscus tears. Future research should include well-designed prospective studies assessing more demanding tasks.

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Outcomes of Arthroscopic All-Inside Repair are Improved Compared to Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tears ePoster Presentation Kyoung-Ho Yoon, MD, PhD, Prof., KOREA, REPUBLIC OF Jae-Young Park, MD, KOREA, REPUBLIC OF Cheol Hee Park, MD, PhD, KOREA, REPUBLIC OF Sang-Gyun Kim, MD, PhD, KOREA, REPUBLIC OF Yoon-Seok Kim, MD, KOREA, REPUBLIC OF Hee Sung Lee, MD, KOREA, REPUBLIC OF Sung Hyun Hwang, MD, KOREA, REPUBLIC OF Dae Keun Suh, MD, PhD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF
A New Arthroscopic Pull-In All-Suture Anchor Meniscus Root Tear Repair Shows Comparable Biomechanical Properties as Conventional Trans-Osseous Pull-Out and Anchor Repair ePoster Presentation Thorben Briese, MD, GERMANY Amaris Kieninger, MD, GERMANY Elmar Herbst, MD, PhD, GERMANY Johannes Glasbrenner, MD, GERMANY Christian Peez, MD, GERMANY Adrian Deichsel, MD, GERMANY Maurice Balke, MD, GERMANY Jens Wermers, MD, GERMANY Matthias Klimek, M. Sc., GERMANY Michael J. Raschke, MD, Prof., GERMANY Christoph Kittl, MD, MD(res), GERMANY
"Repair Or Resect? That Is The Question!" Inside-Out Repair Of Long Meniscus Tears Is Used to Identify Prognostic Factors and Improve Decision-Making ePoster Presentation Iftach Hetsroni, MD, Associate Prof., ISRAEL Yakir Carmeli, B.Ed., ISRAEL Shiri Bretter, M.ed, ISRAEL Gabriel Marino, MD, ISRAEL Ayelet Gonen-Vonkler, BA, ISRAEL Altaieb Agbaria, MD, ISRAEL Gideon Mann, MD, Prof., ISRAEL Nissim Ohana, MD, ISRAEL Moshe Ayalon, PhD, ISRAEL
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Polyurethane Meniscal Scaffold In Postmeniscectomy Syndrome Presented Good Clinical Results At Minimum 10-Years Of Follow-Up ePoster Presentation Maximiliano Ibañez, MD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Pablo E. Gelber, MD, PhD, SPAIN Simone Perelli, MD,PhD, SPAIN Daniel Pérez-Prieto, MD, SPAIN Àngel Masferrer-Pino, MD PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Predictors of Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction With Concurrent Treatment of Bucket-Handle Meniscus Tears ePoster Presentation Gregory Perraut, MD, UNITED STATES Rachel E Cherelstein, BS, UNITED STATES Alexandra Galel, MD, UNITED STATES Laura Keeling, MD, UNITED STATES Christopher M Kuenze, PhD, UNITED STATES Andrew Curley, MD, UNITED STATES David X. Wang, MD, UNITED STATES Kaitlin A Malekzadeh, , UNITED STATES Edward S. Chang, MD, UNITED STATES
Less Than 10% Failure Rate in Patients with Bucket-Handle Meniscal Tear Repair After 4 Years Follow-Up ePoster Presentation Tomas Alfredo Esteves, MD, ARGENTINA Ignacio Astore, ARGENTINA Carlos H. Yacuzzi, MD, ARGENTINA Matias Costa-Paz, MD, PhD., ARGENTINA Juan Pablo Zicaro, MD, ARGENTINA
Predictors of The Ten-Year Patient-Reported Outcome Measures After Collagen Meniscus Implant (CMI) For Partial Meniscus Deficiency ePoster Presentation Alberto Grassi, PhD, ITALY Gian Andrea Lucidi, MD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Giacomo Dal Fabbro, ITALY Nicola Pizza, MD, ITALY Marianna Viotto, ITALY Luca Ambrosini, MD, ITALY Stefano Zaffagnini, MD, Prof., ITALY

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Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies

Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies

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Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies

Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies

Methods

Results

Conclusion

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