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Analysis of displacement and deformation of the medial meniscus with a horizontal tear using a three-dimensional computer model

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The displacement and deformation of the knee meniscus significantly affect its roles; however, little is known about the displacement and deformation patterns of a torn medial meniscus. The objective of this study was to evaluate quantitatively the patterns of displacement and deformation in horizontally torn medial menisci during knee flexion.

Methods

Twenty patients with horizontally torn medial menisci underwent three-dimensional (3-D) magnetic resonance imaging at varying degrees of knee flexion, and 3-D computer models of the tibia, tibial articular cartilage, and meniscus were generated. Based on these, the size of the horizontal tear (% tear) was evaluated and defined as the circumferential ratio between the length of the horizontal tear and that of the entire meniscus. The 3-D meniscus models were automatically superimposed over images taken at 0, 20, 40, and 60° of knee flexion by the voxel-based registration method. Meniscal motion and deformation during knee flexion were visualized and quantitatively calculated on the mid-sagittal plane. Correlations between the size of horizontal tear, displacement/deformation of torn menisci, and clinical symptoms were evaluated after conservative treatment for 3 months.

Results

The % tear was 35.7 ± 12.5 % (range 13.7–55.5 %). During knee flexion, all torn menisci moved posteriorly, with gradual widening of horizontal and vertical gaps (p < 0.05). A direct correlation was observed between % tear and change in the vertical tear gap during knee flexion (p < 0.05). There was an inverse correlation between Lysholm score and % tear (p < 0.05).

Conclusion

Medial meniscal horizontal tears widen and deform during knee flexion, and % tear correlates with the change in the vertical gap. Patients with a lower % tear are more capable of performing activities of daily living after conservative treatment. This method may help clarify the cause of pain in patients with medial meniscus tears as well as facilitate the selection of an appropriate treatment plan.

Level of evidence

Case series, Level IV.

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Authors and Affiliations

  1. Department of Sports Orthopedics, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan

    Hiroshi Amano

  2. Department of Orthopedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Hiroshi Amano, Takehiko Iwahashi, Tatsuo Mae & Hideki Yoshikawa

  3. Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, S1-w16, Chu-ou-ku, Sapporo, 060-8543, Japan

    Tomoyuki Suzuki

  4. Faculty of Rehabilitation Science, Osaka Health Science University, 1-9-27, Temma, Kita-ku, Osaka, 530-0043, Japan

    Norimasa Nakamura

  5. Locomotor Biomaterial Limited to the Joint Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Kazuomi Sugamoto

  6. Osaka Yukioka College of Health Science, 1-1-41, Sojiji, Ibaraki, Osaka, 567-0801, Japan

    Konsei Shino

  7. Department of Health and Sport Sciences, Osaka University Graduate School of Medicine, 1-17, Machikaneyama, Toyonaka, Osaka, 560-0043, Japan

    Ken Nakata

Authors
  1. Hiroshi Amano
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  2. Takehiko Iwahashi
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  3. Tomoyuki Suzuki
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  4. Tatsuo Mae
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  5. Norimasa Nakamura
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  6. Kazuomi Sugamoto
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  7. Konsei Shino
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  8. Hideki Yoshikawa
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  9. Ken Nakata
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Corresponding author

Correspondence to Hiroshi Amano.

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Amano, H., Iwahashi, T., Suzuki, T. et al. Analysis of displacement and deformation of the medial meniscus with a horizontal tear using a three-dimensional computer model. Knee Surg Sports Traumatol Arthrosc 23, 1153–1160 (2015). https://doi.org/10.1007/s00167-014-2931-7

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  • DOI: https://doi.org/10.1007/s00167-014-2931-7

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