Traumatic anterior cruciate ligament tear and its implications on meniscal degradation: a preliminary novel lapine osteoarthritis model.
ABSTRACT Injury patterns of the meniscus following impact trauma resulting in anterior cruciate ligament (ACL) rupture are not well understood. This study explored the spatial and temporal distribution of meniscal tears in a novel in vivo lapine model.
Skeletally mature Flemish Giant rabbits were subjected to either tibiofemoral impaction resulting in ACL rupture or surgical ACL transection. Meniscal damage was assessed acutely and after 12 wk for traumatically torn, and after 12 wk in ACL transected animals. Morphological grading was assessed using previously established criteria, and descriptions of meniscal damage were diagnosed by a Board certified orthopedist. Histological assessment was also made on 12 wk traumatically torn and ACL transected animals using Fast-Green/Safranin-O staining.
Traumatic ACL rupture resulted in acute tears predominately in the lateral menisci. Animals subjected to both surgical transection and traumatic ACL rupture experienced degradation of the lateral and medial menisci 12 wk after injury. However, traumatic ACL rupture resulted in acute lateral damage and chronic degradation of the menisci, as well as more severe degradation of the menisci 12 wk after injury.
This study showed that unconstrained high-intensity impacts on the tibiofemoral joint lead to meniscal damage in conjunction with ACL ruptures. Both acute and chronic changes to the menisci following traumatic impaction were observed. This research has implications for the future use of lapine models for osteoarthritis, as it incorporates traumatic loading as a more realistic mode contributing to the progression of osteoarthritis (OA) compared to surgically transected models.
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ABSTRACT: The principal functions of the meniscus are load transmission and shock absorption, based on the meniscal collagen architecture, the biochemical fluid composition, and the proteoglucan-collagen meshwork. The mobile menisci transmit 50-90% of load over the knee joint, depending on knee flexion angle, femoral translation and rotation. The meniscus contributes to knee joint proprioception and probably also to joint stability. Late consequences of total and partial meniscectomy are radiographic osteoarthritis, with a varying percentage of these patients having symptoms. Malalignment, concomitant articular cartilage lesions, and ligament instability are absolute risk factors, while age, lateral compartment, and continued sport activity are relative risk factors. Acute reinsertion of meniscal tears in the red-red or red-white zones can be performed successfully by arthroscopic technique. Also in chronic tears stable healing can be expected in most cases, if the scar tissue is resected.Scandinavian Journal of Medicine and Science in Sports 07/1999; 9(3):134-40. · 2.87 Impact Factor
Article: Proprioception after rehabilitation and reconstruction in knees with deficiency of the anterior cruciate ligament: a prospective, longitudinal study.[show abstract] [hide abstract]
ABSTRACT: We assessed proprioception in the knee using the angle reproduction test in 20 healthy volunteers, ten patients with acute anterior instability and 20 patients with chronic anterior instability after reconstruction of the anterior cruciate ligament (ACL). In addition, the Lysholm-knee score, ligament laxity and patient satisfaction were determined. Acute trauma causes extensive damage to proprioception which is not restored by rehabilitation alone. Three months after operation, there remained a slight decrease in proprioception compared with the preoperative recordings, but six months after reconstruction, restoration of proprioception was seen near full extension and full flexion. In the mid-range position, proprioception was not restored. At follow-up, 3.7 +/- 0.3 years after reconstruction, there was further improvement of proprioception in the mid-range position. There was no difference between open and arthroscopic techniques. The highest correlation was found between proprioception and patient satisfaction. After reconstruction of the ACL reduced proprioception may explain the poor functional outcome in some patients, despite restoration of mechanical stability.Journal of Bone and Joint Surgery - British Volume 09/2000; 82(6):801-6. · 2.83 Impact Factor
Article: Proprioception and joint stability.[show abstract] [hide abstract]
ABSTRACT: In the present paper the current clinical knowledge about proprioception is given for the shoulder, knee, ankle, elbow and the radiocarpal joint. Proprioceptive capabilities are decreased after joint injuries such as ACL or meniscus tears, shoulder dislocation, ankle sprain and in joints with degenerative joint disease. Some surgical procedures seem to restore the proprioceptive abilities; others do not. Elastic knee bandages or ankle braces increase different proprioceptive factors like ankle reproduction capability or sports-specific abilities. The present information on proprioception will influence our clinical practice in the future. We should choose surgical procedures that not only reconstruct the anatomy, but also the neurophysiologic feed-back mechanism.Knee Surgery Sports Traumatology Arthroscopy 02/1996; 4(3):171-9. · 2.21 Impact Factor