Deep medial collateral ligament plays a stabilising role under degenerative medial meniscus root tears.

IF 3.3 2区医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-02-20 DOI:10.1002/ksa.12610

Luis Fernando Z Funchal, Leonardo Galibern, Rafael Ortiz, Diego C Astur, Moises Cohen, Carlos R Roesler, Eduardo A Fancello

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引用次数: 0

Abstract

Purpose: Several posterior medial meniscal root (PMMR) repair techniques have been developed to restore the load-bearing function of the meniscus and reduce extrusion. The medial meniscotibial ligament (MMTL) has been shown to play a significant role in meniscal stability. This study evaluates the stabilising function of the MMTL by directly influencing the force exerted on the PMMR during weight-bearing and valgus motion of the knee. Our aim is to investigate whether loss of MMTL integrity is a determining factor in PMMR subluxation.

Methods: Using a 3D model of the knee with parameters from experimental studies, compressive and valgus loading scenarios were simulated using the finite element method to analyse the mechanical response of different knee structures. To investigate the correlation between the integrity of the MMTL and the force acting on the PMMR, different degrees and types of injuries to both structures were modelled for comparison with the healthy joint, providing insights into their importance in preventing or correcting extrusion.

Results: During compressive loading, tears in the MMTL and PMMR result in a 5.8% and 30.9% increase in meniscal extrusion, respectively, while a combined injury results in a 43.9% increase, indicating that the MMTL provides a secondary constraint against extrusion. Moreover, the importance of the MMTL in restraining extrusion becomes more pronounced as the PMMR weakens, as is typical in degenerative tears. Finally, during valgus motion, the MMTL prevents separation of the meniscus from the tibial plateau and reduces strain/stress on the PMMR.

Conclusion: The integrity of the MMTL plays a crucial role in reducing meniscal extrusion and PMMR overload, particularly when the root is affected by degenerative tears. Therefore, surgical repair of the MMTL can improve meniscal function, potentially reducing the risk of osteoarthritis and should be considered as a better treatment strategy for PMMR tears.

Level of evidence: Level III.

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).