Meniscal root tears and repairs
Date
2018
Authors
Steineman, Brett Daniel, author
Haut Donahue, Tammy L., advisor
LaPrade, Robert F., committee member
Goodrich, Laurie R., committee member
Heyliger, Paul R., committee member
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Abstract
Meniscal root tears are defined as radial tears of the meniscal insertions and lead to an inability for the menisci to transmit compressive loads into circumferential hoop stresses. These are common among the posterior meniscal insertions due to acute or chronic conditions. Anterior root tears have also been shown to occur from iatrogenic injury during anterior cruciate ligament reconstructions; however, the relationship between anterior insertions and the anterior cruciate ligament are understudied. Root tears of the posterior insertions lead to measurable osteoarthritis within a year if left untreated. Despite this, changes to tissue characteristics due to anterior root tears are unknown. If untreated anterior roots result in tissue degeneration, then it is important for both anterior and posterior root tears to be repaired to prevent, or at least delay, the onset of osteoarthritis. Meniscal root repair techniques have been developed to prevent joint degeneration following meniscal root tears; however, clinical studies of root repairs show that meniscal extrusion and joint degeneration are not completely prevented. This limited repair success may be due to inaccurate placement of repairs during surgery or from repair loosening postoperatively as early as during rehabilitation. The goals of this work are to better understand anterior root tears and to investigate potential causes for insufficient meniscal root repairs. Thus, the aims are to: 1) Quantify the overlap between the anterior cruciate ligament and the anterolateral meniscal insertion in the coronal and sagittal planes. 2) Assess early in vivo degeneration after untreated anterior meniscal root tears. 3) Determine the extent of repair loosening and recovery due to short-term rehabilitation. 4) Develop finite element knee models to determine the effect of repair placement and loosening on knee mechanics. The completion of this project will improve clinical practice and basic scientific knowledge of current issues facing meniscal root tears and repairs.
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Subject
meniscal root repair
meniscus
sports medicine
meniscal root tear
mechanics
orthopaedics