Autologous semitendinosus meniscus graft significantly improves knee joint kinematics after complete lateral meniscectomy

Meniscal injuries are among the most common injuries within the knee joint. Dependent on the localisation and type of meniscus injury, detrimental arthroscopic meniscectomy procedures cannot always be avoided. To overcome the devastating meniscectomy effects and delay the onset of osteoarthritis (OA), several options have been developed for total meniscus replacement.

Andreas M. Seitz et al conducted a study to investigate the potential of a doubled semitendinosus (ST) and a single gracilis tendon (GT) lateral meniscus autograft to restore the knee joint kinematics and tibiofemoral contact after total lateral meniscectomy (LMM).

The study was conducted at – “ Institute of Orthopedic Research and Biomechanics, Center of Trauma Research Ulm, University Medical Center, Ulm University, Helmholtzstrasse, Ulm, Germany. It has been published in ‘Knee Surgery, Sports Traumatology, Arthroscopy’ journal.

Fourteen human knee joints were tested intact, after LMM and after ST and GT meniscus autograft treatment under an axial load of 200 N during full range of motion (0°–120°) and four randomised loading situations: without external moments, external rotation, valgus stress and a combination of external rotation and valgus stress using a knee joint simulator. Non-parametric statistical analyses were performed on joint kinematics and on the tibiofemoral contact mechanics.

Key findings of the study were:

• LMM led to significant rotational instability of the knee joints (p<0.02), which was significantly improved after ST autograft application (p<0.04), except for knee joint flexions>60°.

• The GT autograft failed to restore the joint kinematics.

• LMM significantly increased the tibiofemoral contact pressure (p<0.03), while decreasing the contact area (p<0.05).

• The ST autograft was able to restore the contact mechanics after LMM (p< 0.02), while the GT replacement displayed only an improvement trend.

The authors concluded that – “The doubled ST lateral meniscus autograft improved the knee joint kinematics significantly and restored the tibiofemoral contact mechanics almost comparable to the native situation. Thus, from a biomechanical point of view, ST meniscus autografts might be a potential treatment alternative for patients who are indicated for meniscus allograft transplantation.”

Further reading:

Autologous semitendinosus meniscus graft significantly improves knee joint kinematics and the tibiofemoral contact after complete lateral meniscectomy, Andreas M. Seitz, Janina Leiprecht et al, Knee Surgery, Sports Traumatology, Arthroscopy (2023) 31:2956–2965, https://doi.org/10.1007/s00167-022-07300-z