Menisectomy Project Summary

Meniscal tears are among the most common injury seen in orthopaedic surgery. Despite the fact that arthroscopic partial meniscectomy is successful in returning patients to their previous level of activity, the results in elite athletes have not been as successful. College football players that develop meniscal tears are at higher risk for not being able to play in the NFL, and NFL players with a meniscal tear are more likely to have a shortened career.

The biomechanical and clinical consequences of arthroscopic partial menisectomy have been documented in many studies. When the medial meniscus is completely removed, femoral condyle contact area significantly decreases by 75% and peak contact pressure increases by 235%. Total lateral menisectomy decreases contact area by 40% to 50% and also significantly increases peak contact pressure by 200% to 300% of normal. Although clinical outcomes are good even with long-term follow-up, there are radiographic changes that suggest that partial menisectomy results in cartilage degeneration and increases the risk of osteoarthritis (OA) in the knee. OA of the knee can be severely debilitating and can result in chronic pain, lower activity levels, and the need for a knee replacement.

To date, few studies have used high-resolution MRI techniques to evaluate cartilage changes and alterations in tibiofemoral and meniscus kinematics following meniscal tears. It is unknown if meniscal extrusion, which can be seen following partial meniscectomy, results in a increased risk of cartilage damage or altered kinematics. Further, it is unknown if the cartilage changes seen following surgery are a result of the meniscus tear itself, the partial menisectomy, or other factors. In addition, it is unknown how meniscectomy affects the early biochemical changes in the cartilage following surgery.

The purpose of this study is to use high resolution cartilage sensitive MRI to evaluate the changes seen in the knee following acute meniscus tears in order to determine the effects of meniscal injury and arthroscopic debridement on the knee kinematics and cartilage biochemical properties. We specifically will evaluate alterations in the contact area and meniscal kinematics before and after surgery, and evaluate changes in the cartilage at one year after surgery to evaluate for early articular cartilage changes.

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