TY - JOUR
T1 - Concomitant Meniscotibial Ligament Reconstruction Decreases Meniscal Extrusion Following Medial Meniscus Allograft Transplantation
T2 - A Cadaveric Analysis
AU - Condron, Nolan B.
AU - Knapik, Derrick M.
AU - Gilat, Ron
AU - Vadhera, Amar S.
AU - Farivar, Daniel
AU - Shewman, Elizabeth F.
AU - Yanke, Adam B.
AU - Chahla, Jorge
AU - Cole, Brian J.
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: N.B.C., D.M.K., R.G., A.S.V., D.F., E.F.S., J.C., and B.J.C. report grant funding from Arthrex and the Arthroscopy Association of North America. A.B.Y. reports grants from Arthrex and the Arthroscopy Association of North America, during the conduct of the study; other from AlloSource, grants from Arthrex; other from CONMED Linvatec, JRF Ortho, and Olympus; grants from Organogenesis; other from PatientIQ, Smith & Nephew, and Sparta Biomedical; and grants from Vericel, outside the submitted work. B.J.C. reports grants from Arthrex and Arthroscopy Association of North America, during the conduct of the study; other from Aesculap, National Institutes of Health, and Operative Techniques in Sports Medicine; personal fees from Ossio; personal fees and other from Regentis; other from Smith & Nephew; grants, personal fees, and other from Arthrex; and other from Elsevier Publishing, BandGrip, Acumed LLC, Encore Medical, LP, GE Healthcare, Merck Sharp & Dohme Corporation, SportsTek Medical, Inc, and Vericel Corporation, outside the submitted work. ICMJE author disclosure forms are available for this article online, as supplementary material.
Funding Information:
The authors report the following potential conflicts of interest or sources of funding: N.B.C., D.M.K., R.G., A.S.V., D.F., E.F.S., J.C., and B.J.C. report grant funding from Arthrex and the Arthroscopy Association of North America . A.B.Y. reports grants from Arthrex and the Arthroscopy Association of North America, during the conduct of the study; other from AlloSource, grants from Arthrex; other from CONMED Linvatec, JRF Ortho, and Olympus; grants from Organogenesis; other from PatientIQ, Smith & Nephew, and Sparta Biomedical; and grants from Vericel, outside the submitted work. B.J.C. reports grants from Arthrex and Arthroscopy Association of North America, during the conduct of the study; other from Aesculap, National Institutes of Health, and Operative Techniques in Sports Medicine; personal fees from Ossio; personal fees and other from Regentis; other from Smith & Nephew; grants, personal fees, and other from Arthrex; and other from Elsevier Publishing, BandGrip, Acumed LLC, Encore Medical, LP, GE Healthcare, Merck Sharp & Dohme Corporation, SportsTek Medical, Inc, and Vericel Corporation, outside the submitted work. ICMJE author disclosure forms are available for this article online, as supplementary material .
Publisher Copyright:
© 2022
PY - 2022/11
Y1 - 2022/11
N2 - Purpose: To compare meniscal extrusion (ME) following medial meniscus allograft transplantation (MMAT) with and without meniscotibial ligament reconstruction (MTLR). Methods: Ten cadaveric knees were size-matched with meniscus allografts. MMAT was performed via bridge-in-slot technique. Specimens were mounted in a testing system and ME was assessed via ultrasound anterior, directly over, and posterior to the medial collateral ligament at the joint line under 4 testing conditions: (1) 0° flexion and 0 newtons (N) of axial load, (2) 0° and 1,000 N, (3) 30° and 0 N, and (4) 30° and 1,000 N. For each condition, “mean total extrusion” was calculated by averaging measurements at each position. Next, MTLR was performed using 2 inside-out sutures through the remnant allograft meniscotibial ligament and secured to the tibia using anchors. The testing protocol was repeated. Differences in ME between MMAT alone versus MMAT + MTLR were examined. Within-group differences between the measurement positions, loading states, and flexion angles also were assessed. Results: “Mean total extrusion” was greater following MMAT alone (2.56 ± 1.23 mm) versus MMAT + MTLR (2.14 ± 1.07 mm; P = .005) in the loaded state at 0° flexion. ME directly over the MCL was greater following MMAT alone (3.51 ± 1.00 mm) compared with MMAT + MTLR (2.93 ± 0.79 mm; P = .054). Posteriorly, in the loaded state at 0°, ME was greater following MMAT alone (2.43 ± 1.10 mm) compared with MMAT + MTLR (1.96 ± 0.99 mm; P = .010). In all conditions, ME was greater in the loaded state versus the unloaded state. Conclusions: Following MMAT, the addition of MTLR significantly reduced overall ME when compared with isolated MMAT during loading at 0° of flexion in a cadaveric model; given the small absolute values of change in extrusion, clinical significance cannot be gleaned from these findings. Clinical Relevance: During medial meniscus allograft transplantation, augmentation with meniscotibial ligament reconstruction may limit meniscal extrusion and improve the biomechanical milieu of the knee joint following transplant.
AB - Purpose: To compare meniscal extrusion (ME) following medial meniscus allograft transplantation (MMAT) with and without meniscotibial ligament reconstruction (MTLR). Methods: Ten cadaveric knees were size-matched with meniscus allografts. MMAT was performed via bridge-in-slot technique. Specimens were mounted in a testing system and ME was assessed via ultrasound anterior, directly over, and posterior to the medial collateral ligament at the joint line under 4 testing conditions: (1) 0° flexion and 0 newtons (N) of axial load, (2) 0° and 1,000 N, (3) 30° and 0 N, and (4) 30° and 1,000 N. For each condition, “mean total extrusion” was calculated by averaging measurements at each position. Next, MTLR was performed using 2 inside-out sutures through the remnant allograft meniscotibial ligament and secured to the tibia using anchors. The testing protocol was repeated. Differences in ME between MMAT alone versus MMAT + MTLR were examined. Within-group differences between the measurement positions, loading states, and flexion angles also were assessed. Results: “Mean total extrusion” was greater following MMAT alone (2.56 ± 1.23 mm) versus MMAT + MTLR (2.14 ± 1.07 mm; P = .005) in the loaded state at 0° flexion. ME directly over the MCL was greater following MMAT alone (3.51 ± 1.00 mm) compared with MMAT + MTLR (2.93 ± 0.79 mm; P = .054). Posteriorly, in the loaded state at 0°, ME was greater following MMAT alone (2.43 ± 1.10 mm) compared with MMAT + MTLR (1.96 ± 0.99 mm; P = .010). In all conditions, ME was greater in the loaded state versus the unloaded state. Conclusions: Following MMAT, the addition of MTLR significantly reduced overall ME when compared with isolated MMAT during loading at 0° of flexion in a cadaveric model; given the small absolute values of change in extrusion, clinical significance cannot be gleaned from these findings. Clinical Relevance: During medial meniscus allograft transplantation, augmentation with meniscotibial ligament reconstruction may limit meniscal extrusion and improve the biomechanical milieu of the knee joint following transplant.
UR - http://www.scopus.com/inward/record.url?scp=85134807588&partnerID=8YFLogxK
U2 - 10.1016/j.arthro.2022.06.015
DO - 10.1016/j.arthro.2022.06.015
M3 - Article
C2 - 35772603
AN - SCOPUS:85134807588
SN - 0749-8063
VL - 38
SP - 3080
EP - 3089
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 11
ER -