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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Large Posterolateral Cartilage Slope Is a Risk Factor for Noncontact ACL Injury ePoster Presentation Kensuke Hotta, MD, JAPAN Mitsuru Hanada, MD, PhD, JAPAN Kazuki Nomoto, MD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
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Knee Cartilage and Meniscus in Recreational marathon runners: a MRI T2 * mapping investigation ePoster Presentation Siyu Dai, PhD, CHINA Feng Chen, PhD, CHINA Dingbo Shu, MD, CHINA Fanjing Meng, MD, CHINA Le Wang, MD, CHINA Yanjing Zhang, MD, CHINA Jianping Ding, MD, CHINA
Clinical Result of the Two Stage ACL Reconstruction and Meniscus Allograft Transplantation, Is It Comparable To The Meniscus Allograft Transplantation Alone? ePoster Presentation S. Ali Ghasemi, MD, UNITED STATES Shervin Rashidinia, MD, IRAN, ISLAMIC REPUBLIC OF Adel Mahjoub, MD, UNITED STATES Lawrence S. Miller, UNITED STATES
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
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
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
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
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
Bidirectional Evaluation for the Lateral Meniscal Extrusion After Repairing Isolated Longitudinal Tear ePoster Presentation Akira Tsujii, MD, PhD, JAPAN Seira Sato, MD, PhD, JAPAN Tomoki Ohori, MD, PhD, JAPAN Tatsuo Mae, MD, PhD, JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Yasukazu Yonetani, MD, PhD, JAPAN Masayuki Hamada, MD, JAPAN Ken Nakata, 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
Etiology of Posterior Meniscus Root Tears: Medial vs. Lateral ePoster Presentation Katrin Karpinski, MD, GERMANY Philipp Forkel, MD, GERMANY Martin Häner, MD, GERMANY Wolf Petersen, MD, Prof, GERMANY
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
Biomechanical Effect of Unstable Meniscal Injury on Gait in ACL-Deficient and -Reconstructed Knees ePoster Presentation Kengo Harato, MD, PhD, JAPAN Kohei Nishizawa, PhD, JAPAN Shu Kobayashi, MD, PhD, JAPAN Yasuo Niki, MD, PhD, JAPAN Takeo Nagura, MD, JAPAN
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
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
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
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
Increased Mechanical Axis Malalignment Does Not Lead to Worse Outcomes Following Transtibial Meniscus Root Repair ePoster Presentation Logan M. Good, BS, UNITED STATES Reid Palumbo, BS, UNITED STATES Parker Cavendish, BS, UNITED STATES Eric Milliron, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES James C. Kirven, BS, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES
Lateral Meniscus Root Tear in ACL-Injured Patients Results In High-Grade Rotatory Knee Laxity: A Quantitative Pivot Shift Analysis ePoster Presentation Bálint Zsidai, MD, SWEDEN Gian Andrea Lucidi, MD, ITALY Ryosuke Kuroda, MD, PhD, JAPAN James J. Irrgang, PT, PhD, FAPTA, UNITED STATES Kristian Samuelsson, Prof, MD, PhD, MSc, SWEDEN Stefano Zaffagnini, MD, Prof., ITALY Volker Musahl, MD, Prof., UNITED STATES

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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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