Summary: Lateral meniscus tears significantly impact in vivo knee kinematics, whereas for medial meniscus tears, no differences were observed in kinetics, and limited conflicting evidence for kinematics.

Introduction/Objective:
Extensive ex vivo evidence on the role of the meniscus in load transmission and knee stability has paved the way for the current point of emphasis on preserving the menisci. In contrast to the robust body of work stemming from cadaveric studies, there is a relative paucity of in vivo biomechanics studies on the matter. The primary aim of this study is to systematically review the effect of meniscal tears on in vivo kinematics and kinetics.

Methods

Databases were queried for level I-IV studies reporting baseline data meeting the following criteria: in vivo studies of gait or motion analysis; cohorts with isolated meniscal pathology; available kinematics and/or kinetics outcome measures. Demographic data, method of motion analysis employed, tasks performed, and measured outcomes were extracted and qualitatively appraised. Risk of bias assessment was conducted using the MINORS index. Standardized mean differences with a random effects model were calculated by comparing meniscal tear cohorts and healthy controls whenever allowed by homogeneous outcomes.

Results

Thirteen studies were eligible, with a pooled sample of 176 medial meniscal and 74 lateral meniscal tears. Eleven studies assessed gait, while different tasks such as lunge, step-down, and squatting were assessed in one study each. There was considerable variability in the outcomes, as well as in the method of motion analysis. In terms of gait kinematics relative to healthy control, there is qualitative evidence of increased lateral tibial translation in medial meniscal root pathology, and reduction in the variability of articular motion in medial bucket-handle tears. Meta-analysis revealed statistically significant decreases in peak knee flexion angle during stance (p=.0001) and swing (p<.0001), as well as in the range of adduction-abduction (p<.0001) and internal-external rotation (p<.0001) for the pooled sample of lateral meniscus tears. In terms of kinetics relative to healthy control, while there was qualitative evidence for unloading of the injured knee (decreased peak support moment, knee flexion, and extension moments), meta-analysis failed to demonstrate significant differences for peak knee flexion (p = 0.11) and peak knee adduction moments (p = 0.45). The mean MINORS index score for risk of bias was 19.0, ranging from 15 to 22 (out of a maximum possible score of 24).

Conclusion

There is high heterogeneity in terms of reported outcomes from motion analysis studies assessing isolated meniscus tears and largely limited to gait analysis. Qualitative evidence suggests kinetics changes reflecting mechanisms for unloading the injured joint, and that prior ex vivo findings of impaired knee kinematics from meniscal pathology translate to the in vivo setting. There is statistical evidence of limited sagittal, coronal, and axial plane kinematics for lateral meniscus tears. Future research should include well-designed prospective studies assessing more demanding tasks.

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Bone Bridge Technique For Lateral Meniscal Allograft Transplantation – No Difference In Clinical Outcome Compared To The Soft Tissue Technique ePoster Presentation Rahul Bhattacharyya, MBCHB (Hons), MD (Res), FRCS (Orth), MSc, MRCS, UNITED KINGDOM Harry Krishnan, FRCS(Tr&Orth),MEd(ULT), MBBS, BSc (Hons), UNITED KINGDOM Nicole Bausch, MSc physiotherapy and education, UNITED KINGDOM Adam Richard Pilarski, MBBS, MRCS, MBA, BA (hons), UNITED KINGDOM Niall McGoldrick, MB MCh FRCS (Tr & Orth), IRELAND Peter Thompson, MBChB, UNITED KINGDOM Andrew Metcalfe, PhD, UNITED KINGDOM Tim Spalding, FRCS(Orth), UNITED KINGDOM
Medial Meniscus Repair only Partially Restores In-Vivo Knee Kinematics after ACL Reconstruction ePoster Presentation Alberto Grassi, PhD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Gian Andrea Lucidi, MD, ITALY Erika Pinelli, MsC, ITALY Gregorio Marchiori, MD, ITALY Marco Bontempi, PhD, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
Meniscus Repair Augmentation Using Blood Clot ePoster Presentation Peter T. Myers, AM, MBBS, FRACS, FAOrthA, AUSTRALIA John Dabis, MBBS, MSc SEM, MRCS, FRCS(Tr&Orth), UNITED KINGDOM Michael Goldberg, MBBS, FRACS, AUSTRALIA Andrew Stillwell, MBBS(Hons), FRACS, FA(ortho)A, AUSTRALIA
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Posterior Cruciate Buckling Angle Variations are Associated With Different Patterns of Medial Meniscus Tears in Anterior Cruciate Deficient Knees: Results of a Prospective Comparative Magnetic Imaging Resonance Study ePoster Presentation Simone Cerciello , DR, ITALY Gianluca Ciolli, MD, ITALY Dario Candura, ITALY Michele Mercurio, Prof., MD, ITALY Fabrizio Mocini, MD, ITALY Lorenzo Proietti, MD, ITALY
Anatomical Survival of the Graft After Medial Meniscal Allograft Transplantation is Better in Patients with Lower-Grade ICRS Lesions: MRI-Based Objective Evaluation ePoster Presentation Seong-Il Bin, MD, PhD, KOREA, REPUBLIC OF Jong-Min Kim, MD, PhD, KOREA, REPUBLIC OF Bum-Sik Lee, MD, KOREA, REPUBLIC OF seonjong Lee, MD, KOREA, REPUBLIC OF Ju-Ho Song, MD, KOREA, REPUBLIC OF Ho Yeon Kim, MD, KOREA, REPUBLIC OF Jaejung Ryu, MD, KOREA, REPUBLIC OF
Good Clinical Results After Combined Arthroscopic Meniscal Allograft Transplantation and Autologous Chondrocyte Implantation Using Chondrospheres ePoster Presentation Rainer Siebold, Prof. Dr. med., GERMANY Johannes Pawelczyk, cand. med., GERMANY
Evolution in the Indication of Surgical Treatment on Degenerative Meniscal Tears In the Last 20 Years ePoster Presentation Alejandro Espejo-Reina, MD, MSc, SPAIN Enrique Sevillano-Perez, MD, SPAIN María Josea Espejo-Reina, MD, SPAIN Maximiano Lombardo-Torre, SPAIN Miguel Verdejo-Parrilla, MD, MSc, SPAIN Alejandro Espejo-Baena, MD, SPAIN
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Good Clinical Results And Patient Satisfaction After Arthroscopic Repair of Large Meniscus Bucket Handle Tears of the Knee ePoster Presentation Johannes Pawelczyk, cand. med., GERMANY Rainer Siebold, Prof. Dr. med., GERMANY
Continuous Vertical Inside-Out Versus Traditional Vertical Inside-Out Meniscal Repair: A Biomechanical Comparison ePoster Presentation José Leonardo Rocha De Faria , MD, MSc, BRAZIL Arthur Paiva Grimaldi Santos, M.Sc., BRAZIL Douglas Mello Pavão, MD, MSc, PhD, BRAZIL Mariana Radulski, Medical Student, BRAZIL Ana Carolina Leal, PhD, BRAZIL Ari Digiácomo Ocampo Moré, PhD, BRAZIL Alan de Paula Mozella, PhD, Prof., BRAZIL Joao ANTONIO MATHEUS GUIMARAES, BRAZIL Robert F. LaPrade, MD, PhD, UNITED STATES Carlos Rodrigo De Mello Roesler, PhD, BRAZIL Rodrigo Salim, MD,PhD, BRAZIL
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The Fate of Discoid Lateral Meniscus With and Without Osteochondritis Dissecans of the Lateral Femoral Condyle After Surgery ePoster Presentation Ken Iida, MD, JAPAN Yusuke Hashimoto, MD, PhD, JAPAN Yohei Nishida, MD, JAPAN Junsei Takigami, MD, PhD, JAPAN Tomohiro Tomihara, MD, JAPAN Hiroaki Nakamura, MD, PhD, JAPAN
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Outcomes of Arthroscopic All-Inside Repair are Improved Compared to Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tears ePoster Presentation Kyoung Ho Yoon, MD, PhD, Prof., KOREA, REPUBLIC OF Jae-Young Park, MD, KOREA, REPUBLIC OF Cheol Hee Park, MD, PhD, KOREA, REPUBLIC OF Sang-Gyun Kim, MD, PhD, KOREA, REPUBLIC OF Yoon-Seok Kim, MD, KOREA, REPUBLIC OF Hee Sung Lee, MD, KOREA, REPUBLIC OF Sung Hyun Hwang, MD, KOREA, REPUBLIC OF Dae Keun Suh, MD, PhD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF
Strength-Based Rehabilitation On Clinical Outcomes In Patients Post-Meniscectomy: A Systematic Review and Meta-Analysis ePoster Presentation Prushoth Vivekanantha, MD, CANADA Yi (David) Diao, BMSc, CANADA Dan Cohen, MD, CANADA Ben Murphy, DPT, CANADA Darren L. de SA, MD MBA FRCSC, CANADA
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Concomitant Medial Meniscal Ramp Lesions and Lateral Meniscal Tears with Anterior Cruciate Ligament Injuries are Associated with Anterior Tibial Subluxation in Knee Extension ePoster Presentation Hibiki Kakiage, MD, JAPAN Kazuhisa Hatayama, MD, PhD, JAPAN Satoshi Nonaka, MD, JAPAN Masanori Terauchi, MD, JAPAN Atsufumi Oshima, MD, JAPAN HIrotaka Chikuda, MD, PhD, JAPAN
Mid-Term Clinical And Radiological Outcomes of Lateral Meniscal Allograft Transplantation With Suture-Only Fixation Plus Capsulodesis ePoster Presentation Àngel Masferrer-Pino, MD PhD, SPAIN Rodolfo Morales-Avalos, MD, PhD., MEXICO Maximiliano Ibañez, MD, SPAIN Simone Perelli, MD,PhD, SPAIN Pablo E. Gelber, MD, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Clinical Outcomes After the Repair of Isolated Full Radial Tear at Midbody of Lateral Meniscus - All-Inside Suture Repair vs Trans-Capsular Suture Repair - ePoster Presentation Ryohei Uchida, MD, PhD, JAPAN Shuji Horibe, MD, PhD, JAPAN Yoshinari Tanaka, MD, PhD, JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Yuta Tachibana, M.D., Ph.D., JAPAN Akira Tsujii, MD, PhD, JAPAN Konsei Shino, MD, PhD, JAPAN
New Conservative Treatment Option for Symptomatic Degenerative Medial Meniscus Tear -Ultrasound-Guided Injection of MCL Bursa- ePoster Presentation Junsuke Nakase, MD, PhD, JAPAN Rikuto Yoshimizu, JAPAN Tomoyuki Kanayama, MD, JAPAN Yusuke Yanatori, MD, JAPAN Hiroyuki Tsuchiya, JAPAN
Do All Meniscal Ramp Lesions Require Repair? A Prospective Study Of Ramp Lesions with Concomitant ACL Injury? ePoster Presentation Silvampatti Ramasamy Sundararajan, MS(Orth), INDIA Meet Mehta, MD orthopaedics, INDIA Terence Dsouza, MS, DNB, FNB, INDIA Ramakanth Rajagopalakrishnan, D.ortho, DNB(ortho).D.SICOT, INDIA S Rajasekaran, MS(Orth),DOrth,DNB,FRCS(Ed),FRCS(Lon),MCh(Liv),PhD, INDIA
Arthroscopic Treatment of Meniscal Cysts and Clinical Follow Up ePoster Presentation Sang Hak Lee, MD, PhD, KOREA, REPUBLIC OF Tae Wook Kim, MD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF Jun Bum Park, MD, KOREA, REPUBLIC OF Min-Gyu Kim, MD, KOREA, REPUBLIC OF
Meniscus Transplants Delay Arthroplasty in Patients Over 50 Years of Age ePoster Presentation Kevin R. Stone, MD, UNITED STATES Ann W. Walgenbach, RN, NP, MSN, UNITED STATES Shadera Slatter, MS, UNITED STATES Thomas J. Turek, PhD, UNITED STATES Caroline Ferguson-Dryden, BA, UNITED STATES Marie Dicker, BASc, UNITED STATES Emma Miltenberger, BS, UNITED STATES Riley Horn, BS, UNITED STATES Haley Cowles, BA, UNITED STATES Vivian Liu, BA, UNITED STATES Stephanie Wu, BS, UNITED STATES Mani Vessal, MA, PhD, UNITED STATES
Clinical Outcomes with Meniscal Repair, Between 2019-2020, Viña del Mar, Chile (Preliminary Study) ePoster Presentation Sergio Patricio González Rouse, MD, MSc, MBA, CHILE Raul Roz, MD, CHILE Horacio Alejandro Carvajal Araya, MD, CHILE
Clinical Performance of an All-inside Meniscal Repair Device: A Systematic Literature Review with Meta-Analysis ePoster Presentation Darren L. Johnson, MD, UNITED STATES Paul Souter, BSc, PhD, UNITED KINGDOM Matthew Sedgwick, Ph.D., UNITED KINGDOM
A Comparison of Clinical Outcomes Of Discoid Versus Standard Meniscus Tear Procedures: A Systematic Review ePoster Presentation Yi (David) Diao, BMSc, CANADA Prushoth Vivekanantha, MD, CANADA Dan Cohen, MD, CANADA Yuichi Hoshino, MD, PhD, JAPAN Kanto Nagai, MD, PhD, JAPAN Darren L. de SA, MD MBA FRCSC, CANADA
"Repair Or Resect? That Is The Question!" Inside-Out Repair Of Long Meniscus Tears Is Used to Identify Prognostic Factors and Improve Decision-Making ePoster Presentation Iftach Hetsroni, MD, Associate Prof., ISRAEL Yakir Carmeli, B.Ed., ISRAEL Shiri Bretter, M.ed, ISRAEL Gabriel Marino, MD, ISRAEL Ayelet Gonen-Vonkler, BA, ISRAEL Altaieb Agbaria, MD, ISRAEL Gideon Mann, MD, Prof., ISRAEL Nissim Ohana, MD, ISRAEL Moshe Ayalon, PhD, ISRAEL
Non-Extruded Grafts Result in Better Cartilage Quality after Lateral Meniscal Allograft Transplantation: Quantitative 3-T MRI T2 Mapping ePoster Presentation Seong-Il Bin, MD, PhD, KOREA, REPUBLIC OF Jong-Min Kim, MD, PhD, KOREA, REPUBLIC OF Bum-Sik Lee, MD, KOREA, REPUBLIC OF Hyo Yeol Lee, MD, PhD, KOREA, REPUBLIC OF Ju-Ho Song, MD, KOREA, REPUBLIC OF Ho Yeon Kim, MD, KOREA, REPUBLIC OF Jaejung Ryu, MD, KOREA, REPUBLIC OF
No Dynamic Extrusion of the Medial Meniscus in Ultrasound Examination in Patients with Confirmed Root Tear Lesion ePoster Presentation Katrin Karpinski, MD, GERMANY Theresa Diermeier, MD, GERMANY Lukas Willinger, MD, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Andrea E. Achtnich, Assoc. Prof., GERMANY Wolf Petersen, MD, Prof, GERMANY
Higher Signal Intensity of Repaired Lateral Meniscus on MRI Indicates the Risk Of Residual Rotatory Knee Laxity After ACL Reconstruction ePoster Presentation Daisuke Chiba, MD, PhD, JAPAN Yuji Yamamoto, MD, JAPAN Yuka Kimura, MD, PhD, JAPAN Eiji Sasaki, MD, PhD, JAPAN Takahiro Tsushima, MD, PhD, JAPAN Eiichi Tsuda, Prof., JAPAN Yasuyuki Ishibashi, MD, JAPAN
Biological Augmentation May Play A Role In Obtaining Superior Clinical Outcomes In Meniscal Root Repair With Concomitant Anterior Cruciate Ligament Reconstruction ePoster Presentation Lika Dzidzishvili, MD, PhD, SPAIN Irene Isabel López-Torres, MD, PhD, SPAIN David Sáez, MD, SPAIN Antonio Hernández Diez, MD, SPAIN Emilio Calvo, MD, PhD, MBA, SPAIN
Clinical Characteristics Of Isolated Meniscal Tears During Sports Activities Among Young Athletes ePoster Presentation Yuta Tachibana, M.D., Ph.D., JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Hiroshi Amano, MD, PhD, JAPAN Keisuke Kita, MD, PhD, JAPAN Yasukazu Yonetani, MD, PhD, JAPAN Shuji Horibe, MD, PhD, JAPAN Yoshinari Tanaka, MD, PhD, JAPAN
Morphological Analysis of Discoid Lateral Meniscus on Magnetic Resonance Imaging Comparing Pre- and Postoperative Images ePoster Presentation Shunya Tsuji, MD, JAPAN Masakazu Ishikawa, MD, PhD, JAPAN Naofumi Hashiguchi, MD,MPH, JAPAN Goki Kamei, MD, PhD, JAPAN Atsuo Nakamae, MD, PhD, JAPAN Nobuo Adachi, MD, PhD, JAPAN
The Hidden Lesion of the Knee: Risk Factors Study ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Anis Tebourbi, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Rami Triki, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
Less Than 10% Failure Rate in Patients with Bucket-Handle Meniscal Tear Repair After 4 Years Follow-Up ePoster Presentation Tomas Alfredo Esteves, MD, ARGENTINA Ignacio Astore, MD, ARGENTINA Carlos H. Yacuzzi, MD, ARGENTINA Matias Costa-Paz, MD, PhD, ARGENTINA Juan Pablo Zicaro, MD, ARGENTINA
Polyurethane Meniscal Scaffold In Postmeniscectomy Syndrome Presented Good Clinical Results At Minimum 10-Years Of Follow-Up ePoster Presentation Maximiliano Ibañez, MD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Pablo E. Gelber, MD, PhD, SPAIN Simone Perelli, MD,PhD, SPAIN Daniel Pérez-Prieto, MD, SPAIN Àngel Masferrer-Pino, MD PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Meniscal Ramp Lesion, A Contact Characteristic Analysis In Cadaver ePoster Presentation Artit Boonrod, MD, THAILAND Khananut Jaruwanneechai, MD, THAILAND Sermsak Sumanont, MD, THAILAND Nadhaporn Saengpetch, MD, THAILAND
Comparing the Risk of Iatrogenic Peroneal Nerve Injury in All-inside Lateral Meniscus Repair between Preoperative and Real Arthroscopic Position MRIs ePoster Presentation Chaiwat Chuaychoosakoon, MD, THAILAND Wachiraphan Parinyakhup, MD, THAILAND Tanarat Boonriong, Principal, THAILAND

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Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies

Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies

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Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies

Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies

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