Abstract
Aims: To evaluate different surgical techniques of lateral meniscal allograft transplantation in cadaver knees, and to assess how these techniques affect tibial contact pressures.
Methods: The femoral and tibial shafts of five human cadaver knees were cemented into steel pots. Fresh-frozen irradiated human meniscal allografts were supplied by the East Anglia Tissue Services Department of the National Blood Service.
The knees were mounted into an Instron materials testing machine. Paddles of pressure-sensitive Fuji Prescale Film were inserted into the lateral compartment of the knee, underneath the lateral meniscus. Each knee was then loaded to 700N for 10 seconds. The Fuji Film paddles were digitally scanned and then analysed using Scion Image Analysis software to determine the intra-articular contact pressures.
Contact pressures were then determined after (i) total lateral meniscectomy, (ii) lateral meniscal allograft transplantation using a bone plug-keyhole technique to secure the horn attachments, and (iii) after insertion of the graft by suturing only.
Results: Total lateral meniscectomy led to a mean increase in maximum contact pressures of 103% (s.d. 63). Mean maximum contact pressures after lateral meniscal transplantation with a bone cylinder were 59% (s.d. 60) greater than the intact state, and after suturing only of the graft, were 85% (s.d. 74) greater than the intact knees.
Conclusions: Overall, lateral meniscal transplantation did partially restore contact pressures within the knees, and the use of a graft attached to a bone cylinder appeared to be more effective than just simple suturing of the graft. However, the results varied greatly between the different knees. In two knees, the results of meniscal transplantation were excellent. However, results were poor in knees with inaccurate graft-to-host size matching or where there was significant articular degeneration.
The abstracts were prepared by Mr Roger Smith. Correspondence should be addressed to him at the British Association for Surgery of the Knee, c/o BOA, Royal College of Surgeons of England, 35–43 Lincoln’s Inn Fields, London WC2A 3PN.
