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J Knee Surg 2011; 24(1): 045-054
DOI: 10.1055/s-0031-1275401
ORIGINAL ARTICLE

© Thieme Medical Publishers

Biomechanical Evaluation of a High Tibial Osteotomy with a Meniscal Transplant

Geoffrey S. Van Thiel1 , Rachel M. Frank1 , Aman Gupta3 , Neil Ghodadra1 , Elizabeth F. Shewman3 , Vincent M. Wang2 , Bernard R. Bach1 , Nihkil N. Verma4 , Brian J. Cole1 , Matthew T. Provencher1
  • 1Division of Sports Medicine, Department of Orthopedics, University of Illinois, Chicago, Illinois
  • 2Sports Research Laboratory, Rush University Medical Center, Chicago, Illinois
  • 3Department of Biomechanics, University of Illinois, Chicago, Illinois
  • 4Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, California
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Publication History

Publication Date:
25 March 2011 (online)

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ABSTRACT

This study determines the biomechanical advantage and the optimal configuration of a high tibial osteotomy (HTO) and meniscus transplantation performed concurrently. Six cadaver knees were placed in a spatial frame, and an HTO was completed. Loading points between a mechanical 6 degrees of varus and 8 degrees of valgus were loaded to 800 N for medial meniscal intact, meniscectomized, and transplanted states. Posterior slope was also increased by 3 degrees in these specimens. Contact data was recorded. Peak pressures significantly increased in the meniscectomized state in every degree of varus/valgus (p < 0.05). For both peak and total medial compartment pressures, there was a significant drop (p < 0.001) between neutral and 3 degrees of valgus. Lateral compartment pressures linearly increased from varus to valgus orientation. There was no significant change in the pressure profile of the knee with a 3-degree increase in posterior slope. This biomechanical study confirms the hypothesis that an HTO improves the peak pressures in the medial compartment at all degrees of varus/valgus alignment in the setting of meniscal transplantation. Furthermore, the largest decrease in medial pressures was between neutral and 3 degrees of valgus, suggesting that perhaps neutral aligned knees could benefit from an HTO.

KEYWORDS

Meniscus - transplant - tibial - osteotomy - high

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Geoffrey S Van ThielM.D. M.B.A. 

Division of Sports Medicine, Department of Orthopedics, Rush University Medical Center

1611 W. Harrison Street, 2nd Floor, Chicago, IL 60612

Email: Geoffrey_vanthiel@rush.edu