A study on repair method of type <b>Ⅱ</b>c injury in lateral meniscus popliteal tendon area of porcine knee_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU He ,  DAI Zhu , CHEN Yuxi , FAN Weijie , LIAO Ying , LIU Chao , LIU Jianghua

Specialty of Sports Medicine in Department of Orthopedics, the First Affiliated Hospital, University of South China, Hengyang Hunan, 421001, P. R. China;

Corresponding author：

DAI Zhu, Email: oliverdai@hotmail.com

Keywords：

Knee; lateral meniscus; popliteal hiatus; popliteomeniscal fascicle; repair; porcine

DOI：

10.7507/1002-1892.202304040

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Objective To investigate the repair method of type Ⅱc injury in the lateral meniscus popliteal tendon area based on the porcine knee joint. Methods Eighteen commercially available fresh porcine knee joints were randomly divided into 3 groups (n=6). After preparing a type Ⅱc injury in the lateral meniscus popliteal tendon area, and the anterior (group A), posterior (group B), or anterior and posterior (group C) of the popliteal hiatus (PH) was sutured by vertical mattress. The tension meter was used to apply gradient tensions of 2, 4, 6, 8, and 10 N along the tibial plateau horizontally, respectively, to pull the midpoint of the lateral meniscus popliteal tendon area. The displacement values before modeling, after modeling, and after suture were recorded. The reduction value of lateral meniscus displacement and reduction rate after suture were calculated and compared between groups. Results There was no significant difference between groups (P>0.05) in the displacement values before modeling, after modeling, and after suture under different tensions. There was no significant difference between groups A and C (P>0.05) in the reduction value of lateral meniscus displacement and reduction rate after suture under different tensions. The reduction value of lateral meniscus displacement and reduction rate after suture in group B were lower than those in groups A and C. The reduction value of lateral meniscus displacement under tension of 2 N and the reduction rates under tensions of 2, 4, and 6 N between groups A and B showed significant differences (P<0.05). The reduction value of lateral meniscus displacement and the reduction rate under tensions of 2, 4, and 6 N between groups B and C showed significant differences (P<0.05). Conclusion Suturing the anterior area of PH is the key to repairing type Ⅱc injury of lateral meniscus popliteal tendon area.

Citation： WU He, DAI Zhu, CHEN Yuxi, FAN Weijie, LIAO Ying, LIU Chao, LIU Jianghua. A study on repair method of type Ⅱc injury in lateral meniscus popliteal tendon area of porcine knee. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(7): 856-861. doi: 10.7507/1002-1892.202304040 Copy

1.	Aman ZS, DePhillipo NN, Storaci HW, et al. Quantitative and qualitative assessment of posterolateral meniscal anatomy: defining the popliteal hiatus, popliteomeniscal fascicles, and the lateral meniscotibial ligament. Am J Sports Med, 2019, 47(8): 1797-1803.
2.	Grassi A, Pizza N, Andrea Lucidi G, et al. Anatomy, magnetic resonance and arthroscopy of the popliteal hiatus of the knee: normal aspect and pathological conditions. EFORT Open Rev, 2021, 6(1): 61-74.
3.	Zappia M, Reginelli A, Chianca V, et al. MRI of popliteo-meniscal fasciculi of the knee: a pictorial review. Acta Biomed, 2018, 89(1-S): 7-17.
4.	di Vico G, Simonetta R, Correra G, et al. Popliteomeniscal fascicles tears with lateral meniscus instability: outcomes of arthroscopic surgical technique at mid-term follow-up. Arch Orthop Trauma Surg, 2023, 143(5): 2573-2579.
5.	Guimaraes JB, Facchetti L, Schwaiger BJ, et al. Natural evolution of popliteomeniscal fascicle tears over 2 years and its association with lateral articular knee cartilage degeneration in patients with traumatic anterior cruciate ligament tear. Eur Radiol, 2018, 28(8): 3542-3549.
6.	Suganuma J, Inoue Y, Tani H, et al. Reconstruction of the popliteomeniscal fascicles for treatment of recurrent subluxation of the lateral meniscus. Arthrosc Tech, 2017, 6(2): e283-e290.
7.	D’Addona A, Izzo A, Di Vico G, et al. The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature. J Orthop Surg Res, 2021, 16(1): 148. doi: 10.1186/s13018-021-02290-z.
8.	郑佳鹏, 肖棋, 邓辉云, 等. 外侧半月板腘肌腱区损伤的关节镜下分型和处理. 北京大学学报 (医学版), 2021, 53(5): 891-895.
9.	Zheng J, Xiao Q, Wu Q, et al. Tears of the popliteomeniscal fascicles of the lateral meniscus: an arthroscopic classification. Cartilage, 2021, 13(1_suppl): 256S-261S.
10.	Li Z, Fan W, Dai Z, et al. Widening of the popliteal hiatus on sagittal MRI view plays a critical role in the mechanical signs of discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc, 2021, 29(9): 2843-2850.
11.	Ahn JH, Lee SH, Kim KI, et al. Arthroscopic meniscus repair for recurrent subluxation of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc, 2018, 26(3): 787-792.
12.	Toyooka S, Shimazaki N, Masuda H, et al. Preoperative magnetic resonance imaging as a diagnostic aid for hypermobile lateral meniscus. Diagnostics (Basel), 2021, 11(12): 2276. doi: 10.3390/diagnostics11122276.
13.	Kamiya T, Suzuki T, Otsubo H, et al. Midterm outcomes after arthroscopic surgery for hypermobile lateral meniscus in adults: Restriction of paradoxical motion. J Orthop Sci, 2018, 23(6): 1000-1004.
14.	Steinbacher G, Alentorn-Geli E, Alvarado-Calderón M, et al. Meniscal fixation is a successful treatment for hypermobile lateral meniscus in soccer players. Knee Surg Sports Traumatol Arthrosc, 2019, 27(2): 354-360.
15.	Hashimoto Y, Nishino K, Yamasaki S, et al. Predictive signs of peripheral rim instability with magnetic resonance imaging in no-shift-type complete discoid lateral meniscus. Skeletal Radiol, 2021, 50(9): 1829-1836.
16.	冯华, 洪雷, 耿向苏, 等. 外侧半月板腘肌腱区损伤的缝合方法. 中国运动医学杂志, 2007, (2): 159-163.
17.	戴祝, 陈疾忤, 陈世益, 等. 半月板成形和缝合治疗累及腘肌腱裂孔的盘状软骨损伤. 中国修复重建外科杂志, 2011, 25(1): 13-16.
18.	Li Z, Zhao H, Dai Z, et al. Widening of the popliteal hiatus on magnetic resonance imaging leads to recurrent subluxation of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc, 2020, 28(11): 3532-3538.
19.	Klingele KE, Kocher MS, Hresko MT, et al. Discoid lateral meniscus: prevalence of peripheral rim instability. J Pediatr Orthop, 2004, 24(1): 79-82.
20.	Kim JH, Bin SI, Lee BS, et al. Does discoid lateral meniscus have inborn peripheral rim instability? Comparison between intact discoid lateral meniscus and normal lateral meniscus. Arch Orthop Trauma Surg, 2018, 138(12): 1725-1730.
21.	Shi Q, Wang H, He K, et al. Comparison of the morphology of the anterior cruciate ligament and related bony structures between pigs and humans. Front Vet Sci, 2022, 9: 1045785. doi: 10.3389/fvets.2022.1045785.
22.	Hirose T, Mae T, Ogasawara I, et al. Meniscal displacement and loss of load-transmission function after radial tear of the lateral meniscus in a porcine model: new insights into the functional dynamics of the injured meniscus. Am J Sports Med, 2022, 50(7): 1850-1857.
23.	Seitz AM, Schwer J, de Roy L, et al. Knee joint menisci are shock absorbers: a biomechanical in-vitro study on porcine stifle joints. Front Bioeng Biotechnol, 2022, 10: 837554. doi: 10.3389/fbioe.2022.837554.

1. Aman ZS, DePhillipo NN, Storaci HW, et al. Quantitative and qualitative assessment of posterolateral meniscal anatomy: defining the popliteal hiatus, popliteomeniscal fascicles, and the lateral meniscotibial ligament. Am J Sports Med, 2019, 47(8): 1797-1803.
2. Grassi A, Pizza N, Andrea Lucidi G, et al. Anatomy, magnetic resonance and arthroscopy of the popliteal hiatus of the knee: normal aspect and pathological conditions. EFORT Open Rev, 2021, 6(1): 61-74.
3. Zappia M, Reginelli A, Chianca V, et al. MRI of popliteo-meniscal fasciculi of the knee: a pictorial review. Acta Biomed, 2018, 89(1-S): 7-17.
4. di Vico G, Simonetta R, Correra G, et al. Popliteomeniscal fascicles tears with lateral meniscus instability: outcomes of arthroscopic surgical technique at mid-term follow-up. Arch Orthop Trauma Surg, 2023, 143(5): 2573-2579.
5. Guimaraes JB, Facchetti L, Schwaiger BJ, et al. Natural evolution of popliteomeniscal fascicle tears over 2 years and its association with lateral articular knee cartilage degeneration in patients with traumatic anterior cruciate ligament tear. Eur Radiol, 2018, 28(8): 3542-3549.
6. Suganuma J, Inoue Y, Tani H, et al. Reconstruction of the popliteomeniscal fascicles for treatment of recurrent subluxation of the lateral meniscus. Arthrosc Tech, 2017, 6(2): e283-e290.
7. D’Addona A, Izzo A, Di Vico G, et al. The popliteomeniscal fascicles: from diagnosis to surgical repair: a systematic review of current literature. J Orthop Surg Res, 2021, 16(1): 148. doi: 10.1186/s13018-021-02290-z.
8. 郑佳鹏, 肖棋, 邓辉云, 等. 外侧半月板腘肌腱区损伤的关节镜下分型和处理. 北京大学学报 (医学版), 2021, 53(5): 891-895.
9. Zheng J, Xiao Q, Wu Q, et al. Tears of the popliteomeniscal fascicles of the lateral meniscus: an arthroscopic classification. Cartilage, 2021, 13(1_suppl): 256S-261S.
10. Li Z, Fan W, Dai Z, et al. Widening of the popliteal hiatus on sagittal MRI view plays a critical role in the mechanical signs of discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc, 2021, 29(9): 2843-2850.
11. Ahn JH, Lee SH, Kim KI, et al. Arthroscopic meniscus repair for recurrent subluxation of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc, 2018, 26(3): 787-792.
12. Toyooka S, Shimazaki N, Masuda H, et al. Preoperative magnetic resonance imaging as a diagnostic aid for hypermobile lateral meniscus. Diagnostics (Basel), 2021, 11(12): 2276. doi: 10.3390/diagnostics11122276.
13. Kamiya T, Suzuki T, Otsubo H, et al. Midterm outcomes after arthroscopic surgery for hypermobile lateral meniscus in adults: Restriction of paradoxical motion. J Orthop Sci, 2018, 23(6): 1000-1004.
14. Steinbacher G, Alentorn-Geli E, Alvarado-Calderón M, et al. Meniscal fixation is a successful treatment for hypermobile lateral meniscus in soccer players. Knee Surg Sports Traumatol Arthrosc, 2019, 27(2): 354-360.
15. Hashimoto Y, Nishino K, Yamasaki S, et al. Predictive signs of peripheral rim instability with magnetic resonance imaging in no-shift-type complete discoid lateral meniscus. Skeletal Radiol, 2021, 50(9): 1829-1836.
16. 冯华, 洪雷, 耿向苏, 等. 外侧半月板腘肌腱区损伤的缝合方法. 中国运动医学杂志, 2007, (2): 159-163.
17. 戴祝, 陈疾忤, 陈世益, 等. 半月板成形和缝合治疗累及腘肌腱裂孔的盘状软骨损伤. 中国修复重建外科杂志, 2011, 25(1): 13-16.
18. Li Z, Zhao H, Dai Z, et al. Widening of the popliteal hiatus on magnetic resonance imaging leads to recurrent subluxation of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc, 2020, 28(11): 3532-3538.
19. Klingele KE, Kocher MS, Hresko MT, et al. Discoid lateral meniscus: prevalence of peripheral rim instability. J Pediatr Orthop, 2004, 24(1): 79-82.
20. Kim JH, Bin SI, Lee BS, et al. Does discoid lateral meniscus have inborn peripheral rim instability? Comparison between intact discoid lateral meniscus and normal lateral meniscus. Arch Orthop Trauma Surg, 2018, 138(12): 1725-1730.
21. Shi Q, Wang H, He K, et al. Comparison of the morphology of the anterior cruciate ligament and related bony structures between pigs and humans. Front Vet Sci, 2022, 9: 1045785. doi: 10.3389/fvets.2022.1045785.
22. Hirose T, Mae T, Ogasawara I, et al. Meniscal displacement and loss of load-transmission function after radial tear of the lateral meniscus in a porcine model: new insights into the functional dynamics of the injured meniscus. Am J Sports Med, 2022, 50(7): 1850-1857.
23. Seitz AM, Schwer J, de Roy L, et al. Knee joint menisci are shock absorbers: a biomechanical in-vitro study on porcine stifle joints. Front Bioeng Biotechnol, 2022, 10: 837554. doi: 10.3389/fbioe.2022.837554.

Chinese Journal of Reparative and Reconstructive Surgery

A study on repair method of type Ⅱc injury in lateral meniscus popliteal tendon area of porcine knee

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