Reduction of in situ force through the meniscus with phased inner resection of medial meniscus: an experimental study in a porcine model

PURPOSE: Partial meniscectomy can cause osteoarthritic changes in knees, as inner portion as well as peripheral portion of meniscus is important. The hypothesis of this study was that the amount of the inner resection of medial meniscus affected the in situ forces through the meniscus and the tibial varus and external rotation under axial load. METHODS: Fourteen intact porcine knees were investigated with a six-degree of freedom robotic system and force/moment, and the three-dimensional path of intact knees were recorded by universal force sensor when an axial load of 300-N was applied at four different flexion angles (30°, 60°, 90°, and 120°). The same examination was performed on three phased inner resections (30%, 60%, and 90% width) of the medial meniscus. Finally, all paths were reproduced after total medial meniscectomy, and in situ forces of the medial meniscus were calculated based on the superposition principle. Changes in tibiofemoral varus/valgus and internal/external rotation alignment during an axial load were also calculated. RESULTS: In situ forces of the medial meniscus decreased according to the amount of meniscal resection at all flexion angles. The reduction was significant in knees with inner resections of > 60% width at all flexion angles and even of 30% width at a flexion angle of 120° (p < .05). Incremental changes in the tibiofemoral varus alignment increased depending on the inner resection width at all flexion angles (p < .05). CONCLUSION: The amount of inner resection of the medial meniscus was related to reduction of its in situ forces and increment of the tibial varus rotation under axial load.