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The Journal of Bone and Joint Surgery, Vol 68, Issue 1 71-79, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
The role of the meniscus in the anterior-posterior stability of the loaded anterior cruciate-deficient knee. Effects of partial versus total excision
SC Shoemaker and KL Markolf
The effects of progressive removal of the menisci on the anterior-posterior
force-versus-displacement response of the anterior cruciate-deficient knee
were studied in fresh cadaver specimens at 20 degrees of flexion without
and with tibial-femoral contact force (joint load). In the absence of joint
load, removal of the medial meniscus increased total anterior-posterior
laxity measured at 200 newtons of applied tibial force by 10 per cent, and
subsequent lateral meniscectomy produced an additional 10 per cent
increase. When a bucket-handle tear of the medial meniscus was removed, the
application of joint load caused the tibia to displace (subluxate) forward
on the femur, thereby changing the balance condition of the knee.
Subsequent removal of the remainder of the medial meniscus and complete
lateral meniscectomy both produced additional smaller anterior tibial
subluxations. Changes in total anterior-posterior laxity due to progressive
meniscectomy in the loaded knee were dependent on both the amount of
applied anterior-posterior force and the level of compressive force. At 200
newtons of anterior-posterior tibial force, increases in laxity in the
loaded knee due to progressive meniscal removal were not significantly
different than those recorded in the unloaded condition. At applied forces
of fifty newtons or less, the laxities for loaded specimens were always
significantly less than those for unloaded specimens at comparable stages
of meniscal removal. Bilateral meniscectomy had no significant effect on
the posterior response curve, as posterior tibial translation was
effectively checked by the intact posterior cruciate ligament.(ABSTRACT
TRUNCATED AT 250 WORDS)
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