Experimental and Finite Element Investigations on the Biomechanical Effects of Meniscal Tears in the Knee Joint: A Review

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The knowledge of the complex biomechanical behaviour of the injured knee joints is of paramount importance in various clinical situations. A review of the biomechanical effects of meniscal tears based on experimental and finite element analysis has not been reported in the literature. The objective of this study is to present a review of experimental and finite element investigations on the consequences of meniscal tears such as longitudinal, radial, horizontal cleavage and root tears in the medial and lateral menisci. It is found that larger longitudinal tear in the medial meniscus has a significant impact on the magnitude of strain in the meniscus associated with a dramatic increase in CP in the tibial cartilage. Also, the untreated fragment of the torn meniscus leads to a significant rise in contact pressure in the cartilage resulting in the progressive degeneration of the cartilage surface. The radial tears in the lateral meniscus of more than 66% width and those in the medial meniscus of more than 75% width result in a substantial increase in the contact pressure in the cartilage compared to that in the intact knee joint. The root tears in the menisci demonstrate a significant influence on the biomechanical response of the knee joint. The results of finite element analysis studies are compared with experimental findings. Finally, some recommendations for future work are proposed to predict the realistic biomechanical response of the knee joints with meniscal tears. The results of this study present a rationale that could help surgeons in making clinical decisions when managing patients with meniscal tears.

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[1] A. A. Allen, G. L. Caldwell, and F. H. Fu, Anatomy and Biomechanics of the Meniscus,, Oper. Tech. Orthop., vol.5,no.1, p.2–9 ,January (1995).

Google Scholar

[2] K. Messner and J. Gao, The Menisci of the Knee Joint. Anatomical and Functional Characteristics, and a Rationale for Clinical Treatment,, J. Anat., vol.193,no.2, p.161–178 ,(1998).

DOI: 10.1046/j.1469-7580.1998.19320161.x

Google Scholar

[3] S. Kawamura, K. Lotito, and S. A. Rodeo, Biomechanics and Healing Response of the Meniscus,, Oper. Tech. Sports Med. ,(2003).

Google Scholar

[4] I. D. Mcdermott, S. D. Masouros, and A. A. Amis, Biomechanics of the Menisci of the Knee.,.

Google Scholar

[5] L. A. Setton, F. Guilak, E. W. Hsu, and T. P. Vail, Biomechanical Factors in Tissue Engineered Meniscal Repair,, Clin. Orthop. Relat. Res., vol.367,no.367 Suppl, pp. S254–S272 ,October (1999).

DOI: 10.1097/00003086-199910001-00025

Google Scholar

[6] E. Rath and J. C. Richmond, The Menisci: Basic Science and Advances in Treatment,, Br. J. Sports Med. ,(2000).

Google Scholar

[7] W. G. Rodkey, Basic Biology of the Meniscus and Response to Injury.,, Instr. Course Lect., vol.49, p.189–93 ,(2000).

Google Scholar

[8] A. M. Ahmed, The Load-Bearing Role of the Knee Menisci,, Knee Meniscus: Basic and Clinical Foundations, Raven Press, p.59–73 ,(1992).

Google Scholar

[9] P. Renstrom and R. J. Johnson, Anatomy and Biochechanics of the Menisci,, Clin. Sports Med., vol.9,no.3, p.523–538 ,July 1, (1990).

Google Scholar

[10] M. E. Mononen, J. S. Jurvelin, and R. K. Korhonen, Effects of Radial Tears and Partial Meniscectomy of Lateral Meniscus on the Knee Joint Mechanics during the Stance Phase of the Gait Cycle - A 3D Finite Element Study,, J. Orthop. Res., vol.31,no.8, p.1208–1217 ,August (2013).

DOI: 10.1002/jor.22358

Google Scholar

[11] G. I. Drosos and J. L. Pozo, The Causes and Mechanisms of Meniscal Injuries in the Sporting and Non-Sporting Environment in an Unselected Population,, Knee, vol.11,no.2, p.143–149, (2004).

DOI: 10.1016/s0968-0160(03)00105-4

Google Scholar

[12] I. P. Terzidis, A. Christodoulou, A. Ploumis, P. Givissis, K. Natsis, and M. Koimtzis, Meniscal Tear Characteristics in Young Athletes with a Stable Knee: Arthroscopic Evaluation,, Am. J. Sports Med., vol.34,no.7, p.1170–1175, (2006).

DOI: 10.1177/0363546506287939

Google Scholar

[13] A. Bedi et al., Dynamic Contact Mechanics of Radial Tears of the Lateral Meniscus: Implications for Treatment,, Arthrosc. - J. Arthrosc. Relat. Surg., vol.28,no.3, p.372–381, (2012).

Google Scholar

[14] A. P. Newman, A. U. Daniels, and R. T. Burks, Principles and Decision Making in Meniscal Surgery.,, Arthrosc. J. Arthrosc. Relat. Surg., vol.9,no.1, p.33–51 ,(1993).

Google Scholar

[15] D. E. Cooper, S. P. Arnoczky, and R. F. Warren, Arthroscopic Meniscal Repair.,, Clin. Sports Med., vol.9,no.3, p.589–607 ,July (1990).

DOI: 10.1016/s0278-5919(20)30710-9

Google Scholar

[16] D. T. Shakespeare and H. S. Rigby, The Bucket-Handle Tear of the Meniscus. A Clinical and Arthrographic Study,, J. Bone Jt. Surg. - Ser. B, vol.65,no.4, p.383–387 ,(1983).

DOI: 10.1302/0301-620x.65b4.6874707

Google Scholar

[17] D. J. Dandy, The Arthroscopic Anatomy of Symptomatic Meniscal Lesions,, J. Bone Jt. Surg. - Ser. B, vol.72,no.4, p.628–633 ,(1990).

DOI: 10.1302/0301-620x.72b4.2380218

Google Scholar

[18] D. H. Wright, A. A. De Smet, and M. Norris, Bucket-Handle Tears of the Medial and Lateral Menisci of the Knee: Value of MR Imaging in Detecting Displaced Fragments,, Am. J. Roentgenol., vol.165,no.3, p.621–625 ,(1995).

DOI: 10.2214/ajr.165.3.7645481

Google Scholar

[19] J. H. Ahn, Y. S. Lee, J. C. Yoo, M. J. Chang, S. J. Park, and Y. R. Pae, Results of Arthroscopic All-Inside Repair for Lateral Meniscus Root Tear in Patients Undergoing Concomitant Anterior Cruciate Ligament Reconstruction,, Arthrosc. J. Arthrosc. Relat. Surg., vol.26,no.1, p.67–75 ,January (2010).

DOI: 10.1016/j.arthro.2009.07.007

Google Scholar

[20] T. J. Mulry and L. F. McIntyre, The Classification of Knee Meniscal Cartilage Tears,, Oper. Tech. Sports Med., vol.26,no.4, p.228–232 ,December (2018).

DOI: 10.1053/j.otsm.2018.10.002

Google Scholar

[21] Meniscus Tears and Injuries – Shoulder and Knee Clinic, [Online]. Available: https://www.shoulderandkneeclinic.com/meniscus-tears-and-injuries/. [Accessed: 10-Dec-2019].

Google Scholar

[22] S. C. Mordecai, N. Al-Hadithy, H. E. Ware, and C. M. Gupte, Treatment of Meniscal Tears: An Evidence Based Approach,, World J. Orthop., vol.5,no.3, p.233–241 ,(2014).

Google Scholar

[23] N. F. Sprague, Arthroscopic Meniscal Resection,, The Knee, p.527–57 ,(1994).

Google Scholar

[24] A. Chang et al., Subregional Effects of Meniscal Tears on Cartilage Loss over 2 Years in Knee Osteoarthritis,, Ann. Rheum. Dis., vol.70,no.1, p.74–79 ,January 1, (2011).

DOI: 10.1136/ard.2010.130278

Google Scholar

[25] Meniscus Tears | KNEEguru, [Online]. Available: https://www.kneeguru.co.uk/KNEEnotes/primers/meniscus/meniscus-tears. [Accessed: 02-Sep-2020].

Google Scholar

[26] B. C. Lau, D. Conway, J. Mulvihill, A. L. Zhang, and B. T. Feeley, Biomechanical Consequences of Meniscal Tear, Partial Meniscectomy, and Meniscal Repair in the Knee,, JBJS Rev., vol.6,no.4, p. e3 ,April (2018).

DOI: 10.2106/jbjs.rvw.17.00125

Google Scholar

[27] B. S. Beamer et al., Changes in Contact Area in Meniscus Horizontal Cleavage Tears Subjected to Repair and Resection,, Arthrosc. J. Arthrosc. Relat. Surg., vol.33,no.3, p.617–624 ,March (2017).

DOI: 10.1016/j.arthro.2016.09.004

Google Scholar

[28] R. S. Jones et al., Direct Measurement of Hoop Strains in the Intact and Torn Human Medial Meniscus.,, Clin. Biomech. (Bristol, Avon), vol.11,no.5, p.295–300 ,July (1996).

DOI: 10.1016/0268-0033(96)00003-4

Google Scholar

[29] D. C. Marchetti et al., A Contact Pressure Analysis Comparing an All-Inside and Inside-Out Surgical Repair Technique for Bucket-Handle Medial Meniscus Tears,, Arthrosc. - J. Arthrosc. Relat. Surg., vol.33,no.10, p.1840–1848 ,(2017).

DOI: 10.1016/j.arthro.2017.04.013

Google Scholar

[30] M. G. Muriuki, D. A. Tuason, B. G. Tucker, and C. D. Harner, Changes in Tibiofemoral Contact Mechanics Following Radial Split and Vertical Tears of the Medial Meniscus,, J. Bone Jt. Surg., vol.93,no.12, p.1089–1095 ,June (2011).

DOI: 10.2106/jbjs.i.01241

Google Scholar

[31] A. Bedi et al., Dynamic Contact Mechanics of the Medial Meniscus as a Function of Radial Tear, Repair, and Partial Meniscectomy,, J. Bone Jt. Surg. - Ser. A ,(2010).

Google Scholar

[32] A. L. Zhang, S. L. Miller, D. G. Coughlin, J. C. Lotz, and B. T. Feeley, Tibiofemoral Contact Pressures in Radial Tears of the Meniscus Treated with All-inside Repair, inside-out Repair and Partial Meniscectomy,, Knee, vol.22,no.5, p.400–404, (2015).

DOI: 10.1016/j.knee.2015.05.008

Google Scholar

[33] P. G. Bullough, L. Munuera, J. Murphy, and A. M. Weinstein, The Strength of the Menisci of the Knee as It Relates to Their Fine Structure.,, J. Bone Jt. Surg. - Ser. B, vol.52,no.3, p.564–567 ,August (1970).

DOI: 10.1302/0301-620x.52b3.564

Google Scholar

[34] S. Arno, C. P. Bell, C. Uquillas, I. Borukhov, and P. S. Walker, Tibiofemoral Contact Mechanics Following a Horizontal Cleavage Lesion in the Posterior Horn of the Medial Meniscus,, J. Orthop. Res., vol.33,no.4, p.584–590 ,(2015).

DOI: 10.1002/jor.22809

Google Scholar

[35] M. J. Brown, J. P. Farrell, M. A. Kluczynski, and J. M. Marzo, Biomechanical Effects of a Horizontal Medial Meniscal Tear and Subsequent Leaflet Resection,, Am. J. Sports Med., (2015).

DOI: 10.1177/0363546515623782

Google Scholar

[36] R. Allaire, M. Muriuki, L. Gilbertson, and C. D. Harner, Biomechanical Consequences of a Tear of the Posterior Root of the Medial Meniscus: Similar to Total Meniscectomy,, J. Bone Jt. Surg. - Ser. A ,(2008).

DOI: 10.2106/jbjs.g.00748

Google Scholar

[37] C. D. Harner, C. S. Mauro, B. P. Lesniak, and R. Romanowski, Biomechanical Consequences of a Tear of the Posterior Root of the Medial Meniscus Surgical Technique,, COPYRIGHT© 2009 BY J. BONE Jt. SURGERY, Inc. }B}S, vol.90, p.1922–1953 ,(2008).

DOI: 10.2106/jbjs.i.00500

Google Scholar

[38] J. M. Marzo and J. Gurske-DePerio, Effects of Medial Meniscus Posterior Horn Avulsion and Repair on Tibiofemoral Contact Area and Peak Contact Pressure with Clinical Implications,, Am. J. Sports Med., vol.37,no.1, p.124–129 ,January 30, (2009).

DOI: 10.1177/0363546508323254

Google Scholar

[39] J. G. Kim et al., Tibiofemoral Contact Mechanics Following Posterior Root of Medial Meniscus Tear, Repair, Meniscectomy, and Allograft Transplantation,, Knee Surgery, Sport. Traumatol. Arthrosc., vol.21,no.9, p.2121–2125 ,September 7, (2013).

DOI: 10.1007/s00167-012-2182-4

Google Scholar

[40] J. R. Padalecki et al., Biomechanical Consequences of a Complete Radial Tear Adjacent to the Medial Meniscus Posterior Root Attachment Site,, Am. J. Sports Med., vol.42,no.3, p.699–707 ,March 28, (2014).

DOI: 10.1177/0363546513499314

Google Scholar

[41] K. S. Goyal, T. J. Pan, D. Tran, S. C. Dumpe, X. Zhang, and C. D. Harner, Vertical Tears of the Lateral Meniscus: Effects on in Vitro Tibiofemoral Joint Mechanics,, Orthop. J. Sport. Med., vol.2,no.8, p.1–8 ,(2014).

DOI: 10.1177/2325967114541237

Google Scholar

[42] S. Canale and J. Beaty, Campbell's Operative Orthopaedics e-Book ,(2012).

Google Scholar

[43] G. E. Ode et al., Effects of Serial Sectioning and Repair of Radial Tears in the Lateral Meniscus,, Am. J. Sports Med., vol.40,no.8, p.1863–1870 ,August 11, (2012).

DOI: 10.1177/0363546512453291

Google Scholar

[44] J. L. Koh, T. A. Zimmerman, S. Patel, Y. Ren, D. Xu, and L. Q. Zhang, Tibiofemoral Contact Mechanics with Horizontal Cleavage Tears and Treatment of the Lateral Meniscus in the Human Knee: An in Vitro Cadaver Study,, Clin. Orthop. Relat. Res., vol.476,no.11, p.2262–2270 ,(2018).

DOI: 10.1097/corr.0000000000000464

Google Scholar

[45] I. D. Mcdermott, A. A. Amis, O. Biomechanics, and M. Engineering, The Consequences of Meniscectomy,, J Bone Jt. Surg [Br], vol.88,no.12, p.1549–56 ,(2006).

Google Scholar

[46] C. K. Schillhammer, F. W. Werner, M. G. Scuderi, and J. P. Cannizzaro, Repair of Lateral Meniscus Posterior Horn Detachment Lesions,, Am. J. Sports Med., vol.40,no.11, p.2604–2609 ,November 12, (2012).

DOI: 10.1177/0363546512458574

Google Scholar

[47] A. Perez-Blanca et al., Comparative Biomechanical Study on Contact Alterations After Lateral Meniscus Posterior Root Avulsion, Transosseous Reinsertion, and Total Meniscectomy,, Arthrosc. J. Arthrosc. Relat. Surg., vol.32,no.4, p.624–633 ,April (2016).

DOI: 10.1016/j.arthro.2015.08.040

Google Scholar

[48] C. M. LaPrade, K. S. Jansson, G. J. Dornan, S. D. Smith, C. A. Wijdicks, and R. F. LaPrade, Altered Tibiofemoral Contact Mechanics Due to Pull-out Suture Repairs,, J. Bone Jt. Surg., vol.96,no.6, p.471–479 ,(2014).

DOI: 10.2106/jbjs.l.01252

Google Scholar

[49] J. G. Kim et al., Tibiofemoral Contact Mechanics Following Posterior Root of Medial Meniscus Tear, Repair, Meniscectomy, and Allograft Transplantation,, Knee Surgery, Sport. Traumatol. Arthrosc. ,(2013).

DOI: 10.1007/s00167-012-2182-4

Google Scholar

[50] E. Peña, B. Calvo, M. A. Martínez, D. Palanca, and M. Doblaré, Finite Element Analysis of the Effect of Meniscal Tears and Meniscectomies on Human Knee Biomechanics,, Clin. Biomech.,(2005).

DOI: 10.1016/j.clinbiomech.2005.01.009

Google Scholar

[51] Y. Dong, G. Hu, Y. Dong, Y. Hu, and Q. Xu, The Effect of Meniscal Tears and Resultant Partial Meniscectomies on the Knee Contact Stresses: A Finite Element Analysis,, Comput. Methods Biomech. Biomed. Engin., vol.17,no.13, p.1452–1463 ,(2014).

DOI: 10.1080/10255842.2012.753063

Google Scholar

[52] Y. F. Dong, Y. H. Dong, Q. R. Xu, G. H. Hu, and W. P. Dong, The Effect of Varying Degrees of Radial Meniscal Tears on the Knee Contact Stresses: A Finite Element Analysis,, Adv. Mater. Res., vol.304, p.135–141 ,July (2011).

DOI: 10.4028/www.scientific.net/amr.304.135

Google Scholar

[53] K. Zhang et al., Effect of Degenerative and Radial Tears of the Meniscus and Resultant Meniscectomy on the Knee Joint: A Finite Element Analysis,, J. Orthop. Transl., ,no.January, p.1–12 ,January (2019).

Google Scholar

[54] A. E. Kedgley, T.-H. Saw, N. A. Segal, U. N. Hansen, A. M. J. Bull, and S. D. Masouros, Predicting Meniscal Tear Stability across Knee-Joint Flexion Using Finite-Element Analysis,, Knee Surgery, Sport. Traumatol. Arthrosc., vol.27,no.1, p.206–214 ,January 10, (2019).

DOI: 10.1007/s00167-018-5090-4

Google Scholar

[55] H. R. C. Bao, D. Zhu, G. S. Gu, and H. Gong, The Effect of Complete Radial Lateral Meniscus Posterior Root Tear on the Knee Contact Mechanics: A Finite Element Analysis,, J. Orthop. Sci., vol.18,no.2, p.256–263 ,March (2013).

DOI: 10.1007/s00776-012-0334-5

Google Scholar