Background:Meniscal replacement has become more common in recent years. The meniscal transplant's ability to transfer load effectively depends on its ability to bear circumferential loading.
Hypothesis:Intraoperative pretensioning on the meniscal transplant sutures has a positive influence on meniscal transplants' chondroprotective effect.
Study Design:Controlled laboratory study.
Methods:Thirty-six sheep were divided into 6 groups (n = 6), subjected to a sham operation (group A), a meniscectomy (group B), or a meniscal autograft using tag sutures with different levels of pretensioning (group C, 0 N; group D, 20 N; group E, 40 N; group F, 60 N). Macroscopic (International Cartilage Repair Society score) and histologic evaluations (Mankin score) of the articular cartilage were performed after 6 months.
Results:Higher suture pretension (40 N, 60 N) resulted in less cartilage degeneration than in meniscectomized (P= .047; P= .036) and nonpretensioned (P= .028; P= .015) knees, with International Cartilage Repair Society scores of 1.63 ± 0.57 and 1.66 ± 0.51 in groups E and F, respectively, and scores of 2.40 ± 0.27 and 2.68 ± 0.46 observed after meniscectomy and meniscal transplantation with no pretensioning, respectively. Group F had a significantly better Mankin score of 6.66 ± 2.15 (P= .05) compared with group D. Regarding criterion cells, trends toward less degeneration compared with meniscectomized and nonpretensioned knees (P= .054 and P= .055) were found. The coefficient of variation of the Mankin scores was greater than that of the International Cartilage Repair Society score. Group A had significantly better cartilage than all other groups.
Conclusion:Adequate intraoperative pretensioning has a significant influence on the chondroprotective effect of meniscal transplants but did not prevent the development of articular cartilage degeneration.
Clinical Relevance:The results suggest that intraoperative pretensioning could improve the chondroprotective effect of meniscal transplantation.
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