Abstract
PurposeSelection of a meniscus allograft with a similar three-dimensional (3D) size is essential for good clinical results in meniscus allograft surgery. Direct meniscus sizing by MRI scan is not possible in total meniscectomy and indirect sizing by conventional radiography is often inaccurate. The purpose of this study was to develop a new indirect sizing method, based on the 3D shape of the ipsilateral tibia plateau, which is independent of the meniscus condition.MethodsMRI and CT scans of fifty healthy knee joints were used to create 3D surface models of both menisci (MRI) and tibia plateau (CT). 3D bone models of the proximal 10 mm of the entire and half tibia plateau (with / without intercondylar area) were created in a standardized fashion. For each meniscus, the best fitting “allograft” couple out of all other 49 menisci were assessed by the surface distance of the 3D meniscus (best available allograft), of the 3D tibia plateau (3D-CT) and by the radiographic method of Pollard (2D-RX).Results3D-CT sizing was significantly better by using only the half tibia plateau without the intercondylar area (p < 0.001). But neither sizing by 3D-CT, nor by 2D-RX could select the best available allograft. Compared to 2D-RX, 3D-CT sizing was significantly better for the medial, but not for the lateral meniscus.ConclusionsAutomatized, indirect meniscus sizing using the 3D bone models of the tibia plateau is feasible and more precise than the previously described 2D-RX method.. However, further technical improvement is needed to select always the best available allograft.
Highlights
Partial or total meniscectomy is often a valuable treatment option to improve the symptoms of patients with meniscal tears
Meniscus allograft transplantation has become a powerful tool in the treatment of postmeniscectomy syndrome in young patients with proven clinical and functional efficacy [21]
The aim of this study was, to develop a new indirect meniscus sizing method, that should be independent of the meniscus condition, fully automatized with validated technologies and should improve the accuracy of the entire 3D meniscus shape selection
Summary
Partial or total meniscectomy is often a valuable treatment option to improve the symptoms of patients with meniscal tears. Best biomechanical and clinical results could be achieved by the selection of an allograft with a similar threedimensional (3D) meniscus shape [4, 10, 12, 19, 20, 25]. The ignored 3D shape of the meniscus might lead to an inaccurate meniscus size selection, regrettably corresponding with clinical experience and confirmed by recently published data [1, 6, 9, 13, 14, 17, 22, 23]
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