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The relationship between patellofemoral and tibiofemoral morphology and gait biomechanics following arthroscopic partial medial meniscectomy
Authors:Alasdair R. Dempsey  Yuanyuan Wang  Jonas B. Thorlund  Peter M. Mills  Tim V. Wrigley  Kim L. Bennell  Ben R. Metcalf  Fahad Hanna  Flavia M. Cicuttini  David G. Lloyd
Affiliation:1. Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold Coast Campus, Southport, Australia
2. School of Chiropractic and Sports Science, Murdoch University, Perth, Australia
3. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
4. Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, Australia
5. Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
6. Baker-IDI, Melbourne, Australia
7. School of Sport Science, Exercise and Health, University of Western Australia, Perth, Australia
Abstract:

Purpose

To examine the relationship between tibiofemoral and patellofemoral joint articular cartilage and subchondral bone in the medial and gait biomechanics following partial medial meniscectomy.

Methods

For this cross-sectional study, 122 patients aged 30–55 years, without evidence of knee osteoarthritis at arthroscopic partial medial meniscectomy, underwent gait analysis and MRI on the operated knee once for each sub-cohort of 3 months, 2 years, or 4 years post-surgery. Cartilage volume, cartilage defects, and bone size were assessed from the MRI using validated methods. The 1st peak in the knee adduction moment, knee adduction moment impulse, 1st peak in the knee flexion moment, knee extension range of motion, and the heel strike transient from the vertical ground reaction force trace were identified from the gait data.

Results

Increased knee stance phase range of motion was associated with decreased patella cartilage volume (B = ?17.9 (95 % CI ?35.4, ?0.4) p = 0.045) while knee adduction moment impulse was associated with increased medial tibial plateau area (B = 7.7 (95 % CI 0.9, 13.3) p = 0.025). A number of other variables approached significance.

Conclusions

Knee joint biomechanics exhibited by persons who had undergone arthroscopic partial meniscectomy gait may go some way to explaining the morphological degeneration observed at the patellofemoral and tibiofemoral compartments of the knee as patients progress from surgery.

Level of evidence

III.
Keywords:
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