Biomechanik des Meniskus

 

 Permissions and Reprints All articles of this category

Die Hauptfunktion der knorpeligen Menisken des Kniegelenks ist die Reduzierung des Druckes auf den femoralen und tibialen Gelenkflächen. Die biomechanische Funktion der Menisken wird durch ihre spezielle Anatomie und ihren ultrastrukturellen Aufbau gewährleistet. Daneben kommt auch den meniskotibialen Bändern eine entscheidende Bedeutung zu.

Meniskusverletzungen machen häufig Teil- oder – seltener – die Totalresektion eines Meniskus erforderlich. Dies führt zur signifikanten Erhöhung des Kontaktdruckes und in der Folge nicht selten zu Gelenkarthrose.

Um die Funktionsweise des Meniskus und die Auswirkungen von Verletzungen und operativen Eingriffen auf die Kniegelenkmechanik zu verstehen, ist ein Grundverständnis des anatomischen Aufbaus und der biomechanischen Funktionsweise des Meniskus sowie seiner Materialeigenschaften erforderlich. Dieser Artikel soll dem Orthopäden und Unfallchirurgen einen Überblick über die biomechanische Funktionsweise des Meniskus und seiner operativen Behandlung geben.

• Quellenangaben

• 1 Mow VC, Huiskes R. Basic orthopaedic Biomechanics and Mechano-Biology. 3rd. ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005
  Google Scholar
• 2 Petersen W, Tillmann B. Funktionelle Anatomie der Menisken des Kniegelenks Kollagenfasertextur und Biomechanik. Arthroskopie 1998; 11: 133-135
  CrossrefPubMedGoogle Scholar
• 3 Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med 1982; 10: 90-95
  CrossrefPubMedGoogle Scholar
• 4 Danzig L, Resnick D, Gonsalves M et al. Blood-supply to the normal and abnormal menisci of the human knee. Clin Orthop Relat Res 1983; (172) 271-276
  PubMedGoogle Scholar
• 5 Petersen W, Tillmann B. Structure and vascularization of the knee joint menisci. Z Orthop Grenzgebiete 1999; 137: 31-37
  PubMedGoogle Scholar
• 6 McDermott ID, Masouros SD, Amis AA. Biomechanics of the menisci of the knee. Curr Orthop 2008; 22: 193-201
  CrossrefPubMedGoogle Scholar
• 7 Johannsen AM, Civitarese DM, Padalecki JR et al. Qualitative and quantitative anatomic analysis of the posterior root attachments of the medial and lateral menisci. Am J Sports Med 2012; 40: 2342-2347
  CrossrefPubMedGoogle Scholar
• 8 Johnson DL, Swenson TM, Livesay GA et al. Insertion-site anatomy of the human menisci: gross, arthroscopic, and topographical anatomy as a basis for meniscal transplantation. Arthroscopy 1995; 11: 386-394
  CrossrefPubMedGoogle Scholar
• 9 Kohn D, Moreno B. Meniscus insertion anatomy as a basis for meniscus replacement: a morphological cadaveric study. Arthroscopy 1995; 11: 96-103
  CrossrefPubMedGoogle Scholar
• 10 Messner K, Gao J. The menisci of the knee joint. Anatomical and functional characteristics, and a rationale for clinical treatment. J Anat 1998; 193 (Pt 2) 161-178
  CrossrefPubMedGoogle Scholar
• 11 Abraham AC, Moyer JT, Villegas DF et al. Hyperelastic properties of human meniscal attachments. J Biomech 2011; 44: 413-418
  CrossrefPubMedGoogle Scholar
• 12 Hauch KN, Villegas DF, Haut Donahue TL. Geometry, time-dependent and failure properties of human meniscal attachments. J Biomech 2010; 43: 463-468
  CrossrefPubMedGoogle Scholar
• 13 Villegas DF, Donahue TLH. Collagen morphology in human meniscal attachments: A SEM study. Connective Tissue Res 2010; 51: 327-336
  CrossrefPubMedGoogle Scholar
• 14 Higuchi H, Kimura M, Shirakura K et al. Factors affecting long-term results after arthroscopic partial meniscectomy. Clin Orthop Relat Res 2000; 377: 161-168
  CrossrefPubMedGoogle Scholar
• 15 Petty CA, Lubowitz JH. Does arthroscopic partial meniscectomy result in knee osteoarthritis? A systematic review with a minimum of 8 yearsʼ follow-up. Arthroscopy 2011; 27: 419-424
  CrossrefPubMedGoogle Scholar
• 16 Rangger C, Klestil T, Gloetzer W et al. Osteoarthritis after arthroscopic partial meniscectomy. Am J Sports Med 1995; 23: 240-244
  Google Scholar
• 17 Masouros SD, McDermott ID, Amis AA et al. Biomechanics of the meniscus-meniscal ligament construct of the knee. Knee Surg Sports Traumatol Arthrosc 2008; 16: 1121-1132
  CrossrefPubMedGoogle Scholar
• 18 Pena E, Calvo B, Martinez MA et al. Finite element analysis of the effect of meniscal tears and meniscectomies on human knee biomechanics. Clin Biomech (Bristol, Avon) 2005; 20: 498-507
  CrossrefPubMedGoogle Scholar
• 19 Walker PS, Erkman MJ. The role of the menisci in force transmission across the knee. Clin Orthop Relat Res 1975; 109: 184-192
  CrossrefPubMedGoogle Scholar
• 20 Thompson WO, Thaete FL, Fu FH et al. Tibial meniscal dynamics using three-dimensional reconstruction of magnetic resonance images. Am J Sports Med 1991; 19: 210-216
  CrossrefPubMedGoogle Scholar
• 21 Vedi V, Williams A, Tennant SJ et al. Meniscal movement. An in-vivo study using dynamic MRI. J Bone Joint Surg Br 1999; 81: 37-41
  CrossrefPubMedGoogle Scholar
• 22 Danzig LA, Hargens AR, Gershuni DH et al. Increased transsynovial transport with continuous passive motion. J Orthop Res 1987; 5: 409-413
  CrossrefPubMedGoogle Scholar
• 23 Renström P, Johnson RJ. Anatomy and biomechanics of the menisci. Clin Sports Med 1990; 9: 523-538
  PubMedGoogle Scholar
• 24 Day B, Mackenzie WG, Shim SS et al. The vascular and nerve supply of the human meniscus. Arthroscopy 1985; 1: 58-62
  CrossrefPubMedGoogle Scholar
• 25 Gray JC. Neural and vascular anatomy of the menisci of the human knee. J Sports Orthop Sports Phys Ther 1999; 29: 23-30
  PubMedGoogle Scholar
• 26 Krause WR, Pope MH, Johnson RJ et al. Mechanical changes in the knee after meniscectomy. J Bone Joint Surg Am Vol 1976; 58: 599-604
  PubMedGoogle Scholar
• 27 Kurosawa H, Fukubayashi T, Nakajima H. Load-bearing mode of the knee joint: physical behavior of the knee joint with or without menisci. Clin Orthop Relat Res 1980; (149) 283-290
  PubMedGoogle Scholar
• 28 Voloshin AS, Wosk J. Shock absorption of meniscectomized and painful knees: a comparative in vivo study. J Biomech Eng 1983; 5: 157-161
  CrossrefPubMedGoogle Scholar
• 29 Andrews S, Shrive N, Ronsky J. The shocking truth about meniscus. J Biomech 2011; 44: 2737-2740
  CrossrefPubMedGoogle Scholar
• 30 Lechner K, Hull ML, Howell SM. Is the circumferential tensile modulus within a human medial meniscus affected by the test sample location and cross-sectional area?. J Orthop Res 2000; 18: 945-951
  CrossrefPubMedGoogle Scholar
• 31 Fithian DC, Kelly MA, Mow VC. Material properties and structure-function relationships in the menisci. Clin Orthop Relat Res 1990; (252) 19-31
  PubMedGoogle Scholar
• 32 Tissakht M, Ahmed AM. Tensile stress-strain characteristics of the human meniscal material. J Biomech 1995; 28: 411-422
  CrossrefPubMedGoogle Scholar
• 33 Joshi MD, Suh JK, Marui T et al. Interspecies variation of compressive biomechanical properties of the meniscus. J Biomed Mater Res 1995; 29: 823-828
  CrossrefPubMedGoogle Scholar
• 34 Seitz AM, Galbusera F, Krais C et al. Stress-relaxation response of human menisci under confined compression conditions. J Mech Behav Biomed Mater 2013; 26: 68-80
  CrossrefPubMedGoogle Scholar
• 35 Sweigart MA, Zhu CF, Burt DM et al. Intraspecies and interspecies comparison of the compressive properties of the medial meniscus. Ann Biomed Eng 2004; 32: 1569-1579
  CrossrefPubMedGoogle Scholar
• 36 Seitz A, Kasisari R, Claes L et al. Forces acting on the anterior meniscotibial ligaments. Knee Surg Sports Traumatol Arthrosc 2012; 20: 1488-1495
  CrossrefPubMedGoogle Scholar
• 37 Noyes FR, Grood ES. The strength of the anterior cruciate ligament in humans and Rhesus monkeys. J Bone Joint Surg Am 1976; 58: 1074-1082
  PubMedGoogle Scholar
• 38 Lee SJ, Aadalen KJ, Malaviya P et al. Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med 2006; 34: 1334-1344
  CrossrefPubMedGoogle Scholar
• 39 Seitz AM, Lubomierski A, Friemert B et al. Effect of partial meniscectomy at the medial posterior horn on tibiofemoral contact mechanics and meniscal hoop strains in human knees. J Orthop Res 2012; 30: 934-942
  CrossrefPubMedGoogle Scholar
• 40 Fukubayashi T, Kurosawa H. The contact area and pressure distribution pattern of the knee. A study of normal and osteoarthrotic knee joints. Acta Orthop Scand 1980; 51: 871-879
  CrossrefPubMedGoogle Scholar
• 41 Haemer JM, Wang MJ, Carter DR et al. Benefit of single-leaf resection for horizontal meniscus tear. Clin Orthop Relat Res 2007; 457: 194-202
  PubMedGoogle Scholar
• 42 Chatain F, Adeleine P, Chambat P et al. A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy 2003; 19: 842-849
  CrossrefPubMedGoogle Scholar
• 43 Simpson DA, Thomas NP, Aichroth PM. Open and closed meniscectomy. A comparative analysis. J Bone Joint Surg Br 1986; 68: 301-304
  PubMedGoogle Scholar
• 44 Marzo JM, Gurske-DePerio J. Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications. Am J Sports Med 2009; 37: 124-129
  CrossrefPubMedGoogle Scholar
• 45 Kurzweil PR, Friedman MJ. Meniscus: Resection, repair, and replacement. Arthroscopy 2002; 18 (2 Suppl 1) 33-39
  PubMedGoogle Scholar
• 46 Dürselen L, Schneider J, Galler M et al. Cyclic joint loading can affect the initial stability of meniscal fixation implants. Clin Biomech 2003; 18: 44-49
  CrossrefPubMedGoogle Scholar
• 47 Seil R, Rupp S, Jurecka C et al. Der Einfluss verschiedener Nahtstärken auf das Verhalten von Meniskusnähten unter zyklischer Zugbelastung. Unfallchirurg 2001; 104: 392-398
  CrossrefPubMedGoogle Scholar
• 48 Brucker PU, Favre P, Puskas GJ et al. Tensile and shear loading stability of all-inside meniscal repairs: an in vitro biomechanical evaluation. Am J Sports Med 2010; 38: 1838-1844
  CrossrefPubMedGoogle Scholar
• 49 Brucker PU, Favre P, Puskas GJ et al. Influence of test temperature on biomechanical properties of all-inside meniscal repair devices and inside-out meniscus sutures—evaluation of an isolated distraction loading, worst-case scenario. Clin Biomech (Bristol, Avon) 2011; 26: 749-753
  CrossrefPubMedGoogle Scholar
• 50 Dürselen L, Hebisch A, Wagner D et al. Meniscal screw fixation provides sufficient stability to prevent tears from gapping. Clin Biomech 2007; 22: 93-99
  CrossrefPubMedGoogle Scholar
• 51 Vrancken AC, Buma P, van Tienen TG. Synthetic meniscus replacement: a review. Int Orthop 2013; 37: 291-299
  CrossrefPubMedGoogle Scholar
• 52 Sandmann GH, Eichhorn S, Vogt S et al. Generation and characterization of a human acellular meniscus scaffold for tissue engineering. J Biomed Mater Res A 2009; 91: 567-574
  PubMedGoogle Scholar
• 53 Zur G, Linder-Ganz E, Elsner JJ et al. Chondroprotective effects of a polycarbonate-urethane meniscal implant: histopathological results in a sheep model. Knee Surg Sports Traumatol Arthrosc 2011; 19: 255-263
  CrossrefPubMedGoogle Scholar
• 54 Gruchenberg K, Ignatius A, Friemert B et al. In vivo performance of a novel silk fibroin scaffold for partial meniscal replacement in a sheep model. Knee Surg Sports Traumatol Arthrosc 2014; DOI: 10.1007./s00167-014-3009-2.
  PubMedGoogle Scholar
• 55 Kazi HA, Abdel-Rahman W, Brady PA et al. Meniscal allograft with or without osteotomy: a 15-year follow-up study. Knee Surg Sports Traumatol Arthrosc 2015; 23: 303-309
  CrossrefPubMedGoogle Scholar
• 56 Kempshall PJ, Parkinson B, Thomas M et al. Outcome of meniscal allograft transplantation related to articular cartilage status: advanced chondral damage should not be a contraindication. Knee Surg Sports Traumatol Arthrosc 2015; 23: 280-289
  CrossrefPubMedGoogle Scholar
• 57 Samitier G, Alentorn-Geli E, Taylor DC et al. Meniscal allograft transplantation. Part 1: systematic review of graft biology, graft shrinkage, graft extrusion, graft sizing, and graft fixation. Knee Surg Sports Traumatol Arthrosc 2015; 23: 310-322
  CrossrefPubMedGoogle Scholar
• 58 Abat F, Gelber PE, Erquicia JI et al. Suture-only fixation technique leads to a higher degree of extrusion than bony fixation in meniscal allograft transplantation. Am J Sports Med 2012; 40: 1591-1596
  CrossrefPubMedGoogle Scholar

• Zum Weiterlesen und Vertiefen

• 1 Andrews S, Shrive N, Ronsky J. The shocking truth about meniscus. J Biomech 2011; 44: 2737-2740
  CrossrefPubMedGoogle Scholar
• 2 Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med 1982; 10: 90-95
  CrossrefPubMedGoogle Scholar
• 3 Beaufils P, Verdonk R. The Meniscus. Heidelberg: Springer; 2010
  CrossrefGoogle Scholar
• 4 Fithian DC, Kelly MA, Mow VC. Material properties and structure-function relationships in the menisci. Clin Orthop Relat Res 1990; 252: 19-31
  PubMedGoogle Scholar
• 5 Lee SJ, Aadalen KJ, Malaviya P et al. Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med 2006; 34: 1334-1344
  CrossrefPubMedGoogle Scholar
• 6 Masouros SD, McDermott ID, Amis AA et al. Biomechanics of the meniscus-meniscal ligament construct of the knee. Knee Surg Sports Traumatol Arthrosc 2008; 16: 1121-1132
  CrossrefPubMedGoogle Scholar
• 7 McDermott ID, Masouros SD, Amis AA. Biomechanics of the menisci of the knee. Current Orthop 2008; 22: 193-201
  CrossrefPubMedGoogle Scholar
• 8 Mow VC, Huiskes R. Basic orthopaedic Biomechanics and Mechano-Biology. 3rd. ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005
  Google Scholar
• 9 Petersen W, Tillmann B. Funktionelle Anatomie der Menisken des Kniegelenks Kollagenfasertextur und Biomechanik. Arthroskopie 1998; 11: 133-135
  CrossrefPubMedGoogle Scholar
• 10 Vedi V, Williams A, Tennant SJ et al. Meniscal movement. An in-vivo study using dynamic MRI. J Bone Joint Surg Br 1999; 81: 37-41
  CrossrefPubMedGoogle Scholar
• 11 Vrancken AC, Buma P, van Tienen TG. Synthetic meniscus replacement: a review. Int Orthop 2013; 37: 291-299
  CrossrefPubMedGoogle Scholar