Autologous semitendinosus meniscus graft significantly improves knee joint kinematics and the tibiofemoral contact after complete lateral meniscectomy

Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2956-2965. doi: 10.1007/s00167-022-07300-z. Epub 2023 Jan 5.

Abstract

Purpose: The purpose of this study was to investigate the potential of a doubled semitendinosus (ST) and a single gracilis tendon (GT) lateral meniscus autograft to restore the knee joint kinematics and tibiofemoral contact after total lateral meniscectomy (LMM).

Methods: Fourteen human knee joints were tested intact, after LMM and after ST and GT meniscus autograft treatment under an axial load of 200 N during full range of motion (0°-120°) and four randomised loading situations: without external moments, external rotation, valgus stress and a combination of external rotation and valgus stress using a knee joint simulator. Non-parametric statistical analyses were performed on joint kinematics and on the tibiofemoral contact mechanics.

Results: LMM led to significant rotational instability of the knee joints (p < 0.02), which was significantly improved after ST autograft application (p < 0.04), except for knee joint flexions > 60°. The GT autograft failed to restore the joint kinematics. LMM significantly increased the tibiofemoral contact pressure (p < 0.03), while decreasing the contact area (p < 0.05). The ST autograft was able to restore the contact mechanics after LMM (p < 0.02), while the GT replacement displayed only an improvement trend.

Conclusion: The doubled ST lateral meniscus autograft improved the knee joint kinematics significantly and restored the tibiofemoral contact mechanics almost comparable to the native situation. Thus, from a biomechanical point of view, ST meniscus autografts might be a potential treatment alternative for patients who are indicated for meniscus allograft transplantation.

Keywords: Kinematics; Lateral meniscus; Meniscectomy; Tendon autograft; Tibiofemoral contact; Total replacement.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Biomechanical Phenomena
  • Cadaver
  • Hamstring Muscles*
  • Humans
  • Knee Joint / surgery
  • Meniscectomy
  • Menisci, Tibial / surgery
  • Range of Motion, Articular
  • Tibia / surgery
  • Tibial Meniscus Injuries* / surgery