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This Article Full Text Full Text (PDF) All Versions of this Article: 34/12/1941    most recent 0363546506290667v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Becker, R. Articles by Stärke, C. Search for Related Content PubMed PubMed Citation Articles by Becker, R. Articles by Stärke, C. Related Collections Knee Meniscus Biomechanics

Distraction Forces on Repaired Bucket-Handle Lesions in the Medial Meniscus

Roland Becker, MD^*,,, Olaf Brettschneider, MS, Karl-Heinz Gröbel, MD^||, Rüdiger von Versen, MD^¶ and Christian Stärke, MD

From the Department of Orthopaedics and Traumatology, City Hospital Brandenburg, Brandenburg, Germany, Department of Orthopaedics, Otto-von-Guericke-University, Magdeburg, Germany, Department of Anaesthesia, Johanniter Hospital, Stendal, Germany, ^|| Institute of Mechanics, Otto-von-Guericke-University, Magdeburg, Germany, and ^¶ German Institute of Cell and Tissue Transplantation, Berlin, Germany

^* Address correspondence to Roland Becker, MD, Head of the Department of Orthopaedics and Traumatology, City Hospital Brandenburg, Hochstrasse 29, 14770 Brandenburg, Germany (e-mail: roland_becker{at}yahoo.de).

Background: Numerous studies have investigated the biomechanical properties of meniscal repair techniques. One of the most commonly discussed parameters is the failure load in the axis of insertion, although little is known about the distraction forces actually occurring at repaired bucket-handle lesions.

Hypothesis: There are clinically relevant distraction forces on repaired meniscus bucket-handle lesions.

Study Design: Controlled laboratory study.

Methods: Meniscus bucket-handle lesions were created and repaired in human cadaveric knees with a vertical suture made from a braided steel wire. A small-sized load sensor was connected to the wire at the periphery of the meniscus. The distraction forces acting on the lesion were measured at different knee joint angles (0°–120° of flexion) with internal and external rotation and with and without weight loading. Forces in excess of 10 N were considered to have clinical relevance.

Results: Mean forces on the meniscus repair ranged from 1.64 to 4.72 N. Irrespective of the modalities (ie, different flexion angles, weight load, direction of rotation), it was found that the forces were well below the cutoff value of 10 N (P < .01). Increasing flexion angles generally did not cause an increase in distraction forces.

Conclusion: The data suggest that distraction forces are not the primary factor in the mechanical stability of meniscal repair. It must therefore be assumed that other factors such as shear forces are of greater significance.

Clinical Relevance: The results may help to validate the biomechanical properties of different meniscal repair techniques.

Key Words: knee joint • meniscus lesion • human • biomechanics