Meniscal Dimensions Research Articles

Exploring the Morphometric Variations of Knee Menisci: Implications for Meniscal Injury and Surgical Interventions in Orthopedic Practice

Background: The knee menisci are pivotal for knee biomechanics and stability, yet meniscal injuries remain prevalent, necessitating a detailed understanding of meniscal morphology for effective clinical management. This study investigates the morphometric variations of knee menisci and their implications for injury mechanisms and orthopedic interventions. Material & Methods: A cross-sectional study was conducted on 30 cadavers with intact knee joints. Morphometric parameters of the medial and lateral menisci were measured using digital calipers. Statistical analysis, including correlation analyses and significance testing, was performed using SPSS version 23 to explore associations between meniscal dimensions and knee morphology. Results: Significant variations in meniscal dimensions were observed, both within individuals and between the medial and lateral menisci. Correlation analyses revealed nuanced relationships between different morphometric parameters. Notably, weak correlations were found between meniscal dimensions and the lengths of adjacent bones, suggesting a complex interplay between meniscal morphology and knee anatomy. For instance, the correlation coefficient between the length of the femur and the outer circumference of the right medial meniscus was 0.215 (p = 0.291), indicating a moderate positive correlation, although not statistically significant. Similarly, the correlation coefficient between the length of the tibia and the inner circumference of the left lateral meniscus was -0.315 (p = 0.091), suggesting a moderate negative correlation, which also did not reach statistical significance. Conclusion: This study provides valuable insights into knee meniscal morphometry and its clinical implications. The findings emphasize the importance of considering meniscal dimensions in diagnosing and managing meniscal injuries. Despite limitations such as sample size and the use of cadaveric specimens, the results contribute to orthopedic knowledge and highlight the need for further research to validate and expand upon these findings.

Changes in Functional Meniscal Morphology During Skeletal Growth and Maturation.

Little is known on how meniscal morphology develops during skeletal growth and maturation and its subsequent relationship with the corresponding bony anatomy. (1) Meniscal dimensions and morphology would change by age during skeletal growth and maturation in different ways in boys compared with girls. (2) Morphological features of the medial and lateral menisci would correlate to medial and lateral femoral condyle curvatures. Cross-sectional study; Level of evidence, 3. Anatomic features of the medial and lateral menisci were measured on magnetic resonance imaging scans from 269 unique knees (age, 3-18 years; 51% female) with no prior history of injury, congenital or growth-related skeletal disorders, or bony deformities. Morphological shape-based measurements were normalized to tibial plateau width or determined as ratios of meniscal dimensions. The association between age and anatomy was analyzed with linear regression. Two-way analysis of variance with the Holm-Šídák post hoc method was used to compare anatomy between sexes in different age groups. Linear regression was used to evaluate the relationship between femoral condyle curvature radius and meniscal morphology in each compartment after adjusting for age and sex. Meniscal length, width, horn distance, mean cross-sectional area (CSA), and mean height increased with age in both sexes (R2 > 0.1; P < .001). Age-related changes in meniscal morphology were seen in normalized length, width, horn distance, and mean height; width-to-length ratio; horn distance-to-length ratio (lateral meniscus only); normalized mean CSA (except lateral meniscus in girls); and mean tip angle (R2 > 0.04; P < .02). Sex-based differences were also found, with some morphological differences (normalized length and height) throughout development (P < .03) and size differences (length, width, and mean CSA) in later development (P < .01). After adjusting for age and sex, there were significant correlations between medial condyle curvature radius and normalized width, width-to-length ratio, horn distance, horn distance-to-length ratio, mean CSA, and mean height of the medial meniscus (P≤ .041) and between lateral condyle curvature radius and normalized length, mean height, and mean tip angle of the lateral meniscus (P≤ .004). Age-related changes in meniscal dimensions and morphology, most notably a nonuniform growth pattern in meniscal geometry, occurred during skeletal growth and maturation, with different trends in boys than in girls.

Comparative analysis of discoid lateral meniscus size: a distinction between symptomatic and asymptomatic cases.

This study evaluated the differences in meniscal sizes and occupancy between symptomatic and asymptomatic patients diagnosed with discoid lateral meniscus (DLM) using magnetic resonance imaging (MRI) to understand how these variations relate to the presence of symptoms and the patients' age. A retrospective review of 98 patients with DLM was conducted, excluding those with meniscal displacement. Both the width and extrusion of DLM and the percentage of the meniscus to the tibia were measured using mid-coronal and mid-sagittal MRI and compared between symptomatic and asymptomatic DLM groups. The relationships among each parameter, meniscal size, and patient age were evaluated. Symptomatic cases were divided into those with and without horizontal tears on MRI to compare the differences in meniscal morphology. A total of 92 knees from 74 patients were included. Sixty-one knees required surgical intervention for symptomatic DLM, while 31 were asymptomatic and included the contralateral side of symptomatic knees. The symptomatic group exhibited larger morphological variations than the asymptomatic group. Moreover, the sagittal meniscal ratio reduced with age in the asymptomatic group (r = - 0.54, p = 0.002) but remained constant in the symptomatic group. The symptomatic cases with horizontal tears demonstrated larger meniscal dimensions and smaller posterior capsule distances than those without tears. Symptomatic patients with DLM had larger knee morphological changes than asymptomatic ones. Age affected the meniscal occupancy in the sagittal plane only in asymptomatic patients. III.

Age-based comparison of meniscal dimensions between an asymptomatic complete discoid lateral meniscus and normal meniscus: MRI evaluation.

This study aimed to evaluate the meniscal size of asymptomatic discoid lateral meniscus (DLM) and compare it with that of normal lateral meniscus (LM) and to compare changes in meniscal dimensions with age among patients with asymptomatic DLM and those with normal LM using magnetic resonance imaging (MRI). We retrospectively reviewed the medical records, including MRI data, of patients with asymptomatic DLM (DLM group) or normal LM (control group). Width and extrusion of both DLM and normal LM and tibial length were measured and compared using mid-coronal and mid-sagittal MR images. Meniscal size and sagittal and coronal meniscal ratio according to age, as well as differences between DLM and normal menisci, were also evaluated. Thirty-four knees were included in the DLM group, whereas the control group comprised of 50 patients. The DLM group showed significantly less meniscal extrusion, greater coronal width, posterior capsule distance, sagittal meniscal length, and sagittal meniscal ratio than the control group (DLM: 0.1 ± 0.3mm, 23.3 ± 2.2mm, 5.4 ± 2.4mm, 25.1 ± 2.8mm, 61 ± 6%, and control: 0.4 ± 0.4mm, 9.5 ± 2.3mm, 2.5 ± 1.2mm, 30.2 ± 2.6mm, 71 ± 4%, respectively). The coronal meniscal ratio decreased with age in both the control (p = 0.001) and DLM (p = 0.037) groups. The sagittal meniscal ratio (p = 0.001) and minimum height (p = 0.04) decreased and the anterior capsule distance (p = 0.035), posterior capsule distance (p = 0.026), and entire sagittal length (p = 0.005) increased with age in the DLM group, while the distance between the meniscal inner margins (p = 0.019) increased with age in the control group. The meniscal ratio in the sagittal plane of the DLM group was significantly lower than that of the control group. The sagittal meniscal ratio of asymptomatic DLM decreased with age, indicating that the size of asymptomatic DLM does not change with age. III: Retrospective comparative study.

Meniscal Dimensions and its Clinical Implications- A Foetal Cadaveric Study

Introduction: The menisci are made up of fibrocartilage. The menisci are prone for injuries and treated by meniscal repair, meniscectomy and the meniscal allograft transplantation. The knowledge about the morphometry is necessary for orthopaedician, embryologist and morphologist. Aim: To analyse the morphometric parameters of medial and lateral menisci in the knee joint of foetuses. Materials and Methods: A cross-sectional observational study was conducted in the Department of Anatomy, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India, during the year May 2015 to May 2017 in seven males and eight female foetuses with gestational age ranging from 20-37 weeks. After dissection, the morphometric parameters like peripheral and inner length, width and thickness of anterior 1/3rd, middle 1/3rd and posterior 1/3rd of the menisci was measured using digital vernier callipers. ANOVA and paired t-test was used to compare the parameters between gender and sides. Results: The morphometry was studied in 14 male and 16 female knee joints (30 medial and 30 lateral menisci). In the medial menisci width of anterior 1/3rd was significantly narrower than the middle and posterior 1/3rd. In lateral menisci, width of middle 1/3rd was greater than anterior and posterior 1/3rd which was statistically insignificant. There were no statistically significant morphometric differences between gender and sides. Conclusion: The part of the menisci which were narrower was less prone for injuries. The knowledge of the morphometric parameters in particular the width and thickness of the menisci determines the commonest area of injury. This study provides morphometric data of menisci in foetuses as it is scarce.

Variations of cross-sectional meniscal morphology between similar-sized menisci: implications on donor selection for meniscal allograft transplantation.

This study aimed to investigate the morphological variations in the cross-sectional anatomy of the meniscus between similar-sized matched menisci. Knee MRI of 329 patients with intact menisci were retrospectively reviewed, and the meniscal length (ML), meniscal width (MW), and cross-sectional dimensions (meniscal height and width) of the anterior, posterior horns, and the corpus were measured. Patients with similar-sized menisci who had less than 1mm difference in ML and MW were matched. 330 male-to-male medial menisci (MM), 623 male-to-male lateral menisci (LM), 82 female-to-female MM, 233 female-to-female LM, 176 cross-gender MM, and 265 cross-gender LM unique combination of ideally matched pairs (total: 1709) were generated. The disparity in the cross-sectional dimensions, absolute difference, and the paired percent differences was statistically analyzed. The ML and MW in all groups were statistically similar, with a predefined absolute difference of 1mm both for ML and MW (paired percent difference < 5%). The cross-sectional segmental meniscal dimensions were similar within all groups, but the paired percent differences showed high variations between a mean of 12.1-21.5% and up to 150.9%. The paired percent difference of MM in each segmental dimension was similar among different gender combinations. However, segmental paired percent differences of LM showed statistical differences in anterior horn width (AHW) (p: 0.001) and posterior horn width (PHW) (p: 0.001). In subgroup comparisons, the paired percent difference of AHW was higher in the female-to-female group compared to cross-gender (p: 0.023) and male-to-male groups (p: 0.001). The paired percent difference of PHW was smaller in the male-to-male group compared to female-to-female and cross-gender groups (p: 0.001 for both). Segmental cross-sectional anatomy showed wide variations despite strict matching in ML and MW. These variations were present in all gender combinations. The meniscal 3D shape is unique, but acceptable limits of similarity need further research. Retrospective study, Level III.

Meniscal Injury Does Not Significantly Affect the Dimensions of the Intact Meniscus in the Opposite Compartment of the Knee.

Background:Meniscal allograft transplant requires precise matching of the size of the allograft with the dimensions of the recipient knee. Estimation of contralateral meniscal size on magnetic resonance imaging (MRI) has been considered the ideal method to measure menisci before transplant. We questioned whether a contralateral intact meniscus with meniscal injury in the opposite compartment could be used as a reference to determine allograft size. Our question was derived from knowledge of meniscal injury influencing structures of the opposite compartment of the knee, including the meniscus.Purpose:To compare meniscal dimensions between intact meniscus with meniscal injury in the opposite compartment and normal meniscus with a normal opposite compartment.Study Design:Cross-sectional study; Level of evidence, 3.Methods:This observational, cross-sectional study was performed between 2016 and 2017. The control group consisted of 200 knees with normal medial and lateral menisci. The medial intact group consisted of 150 cases of medial intact meniscus with injured lateral meniscus, and the lateral intact group consisted of 150 cases of lateral intact meniscus with injured medial meniscus. All patients were male. Mean age, height, and weight did not differ among groups. We investigated meniscal dimensions on MRI, including anteroposterior and mediolateral lengths, distance between the anterior and posterior horns (AHPH distance), and widths and heights of the anterior and posterior horns and midbody.Results:Most medial meniscal dimensions were similar between the control and medial intact groups, but the AHPH distance was smaller in the medial intact group (P < .001). Likewise, most lateral meniscal dimensions were similar between the control and lateral intact groups, but the AHPH distance was smaller in the lateral intact group (P < .001).Conclusion:Most dimensions of the intact meniscus with meniscal injury in the opposite compartment were similar to those of the normal meniscus with normal opposite compartment. Measuring the dimensions of the contralateral intact meniscus with meniscal injury in the opposite compartment on MRI can be an appropriate method to determine meniscal allograft size.

Morphometric measurements to predict meniscal size in skeletally mature dogs for meniscal transplantation.

To determine a relationship between morphometric measurements (MM) and meniscal dimensions (MD) in the dog. Cadaveric study. Eighteen mixed-breed canine cadavers (22.35 ± 4.06 kg); 36 each of medial and lateral menisci. The following MM were obtained in duplicate: height at scapula, withers, pelvis, rump, and greater trochanter; chest circumference; pelvic circumference; length from occiput to the base of the tail; hock to stifle length (HS); body weight; body condition score; and body fat percentage (BF%). Stifles were disarticulated, and digital photographs of in situ menisci were used to obtain meniscal measurements in duplicate. Morphometric parameters were compared with MD via Pearson correlation (r). A correlation of r ≥ 0.65 was considered strong. The strongest correlation was noted between HS and MD, with r = 0.85 for lateral meniscal width, r = 0.77 for medial meniscal length, and r = 0.76 for medial meniscal width. Lateral meniscal length had the strongest correlation with height at rump (HRu) (r = 0.73). Body weight correlated strongly with meniscal width and fairly with meniscal length. Body condition score and BF% correlated weakly with MD. Hock to stifle length was an easily obtainable variable and was proportional to MD. Hock to stifle length may be considered by tissue banks and veterinary surgeons as a quick and cost effective screening tool for appropriate meniscal sizing in dogs.

Normal meniscal dimensions at different patient ages—MRI evaluation

The purpose of this work is to evaluate the normal meniscal and tibial dimensions in relation to age and gender in different children using conventional MRI sequences. Morphometric measurements of the menisci were retrospectively performed on knee MRIs of children (<18years). All knee MRIs over a 7-year period were collected. Exclusion criteria included: prior knee surgery or diseases involving the knee joint. A total of 186 children were included, 110 boys and 76 girls, with a mean age of 8.2years (range, 0.3-17.8years). Menisci and tibial measurement changes with age and gender as well as differences between the medial and lateral menisci were evaluated. The medial menisci measurements increased with age (p value <0.001). The lateral menisci measurements increased with age (p value <0.001), except for the coronal meniscal width (p= 0.084). Coronal and sagittal percentage of meniscal coverage of the tibia decreased with age (p <0.001). Medial menisci have greater sagittal width and anterior horn height than lateral menisci (p value <0.001). Lateral menisci are larger in their coronal width and height, and sagittal posterior horn height in comparison to medial menisci (p<0.001). Menisci increase in all dimensions in correlation with age; except in the coronal meniscal width, which is a useful dimension to diagnose discoid meniscus on MRI, based on this, it would seem that the currently published size criteria, based on adults, could be applicable to children. The tibia has a faster rate dimension increase in correlation with age in comparison to the menisci.

Meniscal sizing before allograft: Comparison of three imaging techniques

BackgroundAccuracy of meniscal sizing is an important issue before allograft transplantation. To date, there is no consensus on the best imaging method. The purpose of this study was to compare plain radiographs, magnetic resonance imaging (MRI) and computed tomography (CT) arthrography in the assessment of meniscal size. We hypothesized that MRI and CT arthrography had better correlations than plain radiographs. MethodsAll patients operated on by meniscal allograft between January 2005 and May 2015 were screened. Among them, 32 patients had both preoperative radiographs, MRI and CT arthrography of the affected knee. The meniscal dimensions were evaluated, blindly and randomly, using three imaging methods. A correlation analysis between each technique was made. For radiographic methods, an additional comparison was made between original Pollard's method and the modified method (Yoon). Bone dimensions (tibial metaphysis) were also collected, using radiographs and MRI, in order to build new equations allowing determination of meniscal dimensions from those bone measurements. ResultsThe radiographic methods offered satisfying evaluations of the meniscal dimensions in the sagittal plane, without significant difference when compared with CT arthrography or MRI. In the frontal plane, the radiograph methods were less effective. With new equations, allowing determination of meniscal dimensions from tibial plateau dimensions, the mean correlation coefficient was 0.39 (0.14–0.71). ConclusionsThe correlation between radiographic methods and MRI depended on which parameter (frontal or sagittal) was measured. Thus, we proposed a new method for sizing of meniscus, easily measurable from bony landmarks, aiming to improve the accuracy of graft selection.

Differences between sexes in the standard and advanced dimensioning of lateral meniscal allografts

BackgroundThere are many different methods of meniscal allograft measurements, which depend on individual tissue bank procedures. Due to the lack of a standardised method of dimensioning, measurement results may vary between individual cases. Consequently, allograft may be mismatched to the patient's knee anatomy. The purpose of this study was to measure four meniscal dimensions – two standard and two specific – and then compare them between sexes. MethodsFourteen cadaveric lateral menisci (seven male and seven female) were scanned using a microtomography scanner. The obtained three-dimensional (3-D) models of each meniscus were analysed, taking into account four dimensions: circumference, width, central meniscal concavity, and total meniscal volume. The computer researcher was not informed of the original data of the meniscal samples until the calculations were completed. ResultsNo statistical between-sex differences were found in the standard dimensions. The specific dimensions, in turn, presented statistically significant between-sex differences (P>0.05). The mean difference between male and female total volume of the meniscus was equal to 36.59%, and the mean difference between male and female central meniscal concavity surface was equal to 31.22%. ConclusionThis study found that sex should be taken into account as an important factor during a matching procedure performed by tissue bank staff.

Should the meniscal height be considered for preoperative sizing in meniscal transplantation?

Purpose and hypothesisIn preoperative sizing for meniscal transplantation, most authors take into consideration the length and width of the original meniscus, but not its height. This study aimed at evaluating (1) whether the meniscal height is associated with the meniscal length and width, (2) whether the heights of the meniscal segments are associated with the individual’s anthropometric data, (3) whether the heights of the meniscal segments are associated with each other in the same meniscus, and (4) the degree of symmetry of the meniscal dimensions between the right and left knees.MethodsIn this cross-sectional, observational study, two independent radiologists measured the meniscal length, width and height in knee magnetic resonance imaging scans obtained from 25 patients with patello-femoral pain syndrome. Reproducibility of measurements was calculated with intraclass correlation coefficients. Associations between the anthropometric data and the meniscal measurements, the meniscal length and width versus height, and the heights of the meniscal segments in the same meniscus were examined with Pearson’s correlation.ResultsInter-observer reliability was excellent (>0.8) for length and height and good (0.6–0.8) for width measurements. There was also excellent agreement (>0.8) for the length and width of the menisci in the right and left knees. The heights of the horns of the lateral meniscus showed good agreement (0.6–0.8), while the heights of the other meniscal segments had excellent agreement between the sides (>0.8). There were significant associations with generally low (r < 0.5) correlation between the heights of the meniscal segments and the lengths and widths of the menisci, between the meniscal height and anthropometric data, and between the heights of the meniscal segments in the same meniscus. Correlations between anthropometric data and meniscal length and width were generally high (r > 0.7).ConclusionsThere was excellent agreement between the meniscal dimensions of the right and left knees, and a weak association between the meniscal height with the meniscal width and length, between the height of the menisci with anthropometric data and between the heights of the segments in the same meniscus. The height of the meniscal segments may be a new variable in preoperative meniscal measurement.

Anatomical study: comparing the human, sheep and pig knee meniscus.

BackgroundAnimal models are commonly used in investigating new treatment options for knee joint injuries including injuries to the meniscus. The reliability and applicability of these models to replicate findings in humans depends on determining the most suitable animal proxy. Therefore, this study was designed to compare the wet weight, volume and dimensions of the human meniscus with two commonly used animal models: sheep and pig.MethodsHuman menisci (n = 6 pairs) were obtained from the knee joints of cadaveric male donors. Sheep menisci (n = 6 pairs) and pig menisci (n = 22 pairs) were obtained from the stifle joints of adult sheep and pigs. Meniscal wet weight, volume and dimensions of the body were measured and compared among the species. Anatomical dimensions included circumference, width, peripheral height, articular height and superior articular length.ResultsThe circumference of human menisci (lateral: 84.0 mm, medial: 88.7 mm) was significantly longer than that of sheep (lateral: 50.0 mm, medial: 55.5 mm) and pig (lateral: 66.8 mm, medial: 64.9 mm). The majority of the remaining dimensions of the medial and all of the remaining dimensions of the lateral menisci in sheep showed no statistical difference in comparison to the human menisci. The meniscal weight in pig was significantly larger (lateral: 6.4 g, medial: 5.0 g) than the human (lateral: 4.9 g, medial: 4.4 g) and sheep (lateral: 2.5 g, medial: 2.2 g). Porcine meniscal volume (lateral: 6.5 ml, medial: 5.1 ml) was also larger than the human (lateral: 5.0 ml, medial: 4.5 ml) and sheep (lateral: 2.3 ml, medial: 2.2 ml) menisci. The dimensions measured in the pig meniscus were generally larger than human menisci with statistically significant differences in most categories.ConclusionSheep meniscal dimensions more closely matched human meniscal dimensions than the pig meniscal dimensions. This information may help guide the choice of an animal proxy in meniscal research.

Which Are the Most Reliable Methods of Predicting the Meniscal Size for Transplantation?

Background: Although the size of the meniscal allograft is crucial during meniscal transplantation, the accuracy of meniscal measurement methods is still under debate. A number of methods based on radiographic and magnetic resonance imaging (MRI) data as well as on anthropometric data have been proposed, but their reproducibility and reliability are still unclear. Purpose: To compare meniscal length and width as measured by different techniques (anthropometric and plain radiographic) to establish which of these 2 methods is more reliable and cost-effective for determining the meniscal size in comparison to MRI. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The MRI scans and plain radiographic films of 22 patients (44 knees) from a single institution were studied. The width and length of the medial and lateral menisci were measured using specific techniques. Data on sex, age, body weight, and height were used to develop a regression formula for meniscal measurements (comparing both imaging methods) to establish meniscal dimensions. Data validation was achieved using the Pearson correlation, the intraclass correlation coefficient, and the Wilcoxon nonparametric test for all variables, with a significance level established at 95%. Accuracy was established as a 10% measure discrepancy from the gold standard (MRI) and was considered an average between the right and left knees. Results: No statistically significant difference was observed between the right and left knees on radiographic and MRI measurements. The Pollard technique of radiographic measurement overestimated the width of the lateral meniscus when compared with anthropometric measurements (P < .001), considering MRI as the gold standard. The same was observed for MRI measurements of the length of the lateral meniscus in which not only anthropometric but also plain radiographic measurements using the Yoon technique were significantly smaller than those values found with the Pollard technique (P < .001). The anthropometric method underestimated the width and length of the medial meniscus with an accuracy of 68.2% and 63.6%, respectively. The radiographic method was comparable with MRI in establishing all medial meniscal measurements with an accuracy of 93.2% for length and 77.3% for width. Conclusion: Some viable alternatives to MRI have been suggested. For the lateral meniscus, anthropometric data are an alternative for width, and the Yoon method can be used to assess length. For the medial meniscus, the Pollard method is considered a satisfactory alternative. This study emphasized the importance of measuring the width and length of the meniscus independently during preoperative sizing for a meniscal allograft transplantation procedure. Using MRI as a gold standard, the study also proposed other less costly and satisfactory methods of obtaining such measurements.

A cadaveric study of tibial meniscal dimensions and its clinical implication

IntroductionThe knee-joint consists of three articulations in one joint. There are two condyloid joints between condyles of femur and tibia, and third joint is between patella and femur. It is a complex joint because the articular surfaces of the femoral and tibial condyles are not congruent to each other. The tibial menisci play important role in articulation by providing congruent articulating surfaces to tibia and femur.There is very few data related to the morphometric parameters of tibial menisci. Aim of this study was to measure and analyse the dimensions of tibial meniscus in cadavers. MethodsIn the present study, different parameters of tibial meniscus were measured after exposure of knee joint. These measurements were done with the help of digital Vernier calliper. Results and discussionMean length, width and circumference of medial meniscus were 42.28±3.71mm, 31.67±3.40mm and 101.46±6.89mm respectively. Mean widths of anterior horn, body and posterior horn of medial meniscus were 6.48±1.21mm, 8.37±1.54mm, 14.34±2.59mm respectively. Mean thicknesses of anterior horn, body and posterior horn of medial meniscus were 4.81±1.34mm, 5.80±1.25mm and 5.28±1.22mm respectively. Mean length, width and circumference of lateral meniscus were 32.73±3.08mm, 33.22±3.37mm and 97.61± 7.32mm respectively. Mean widths of anterior, body and posterior parts of lateral meniscus were 8.57±1.6mm, 9.79±1.71mm, 9.21±1.28mm. Mean thicknesses of anterior horn, body and posterior horn of lateral meniscus were 3.03±0.94mm, 6.53±1.07mm and 4.76±1.00mm respectively. DiscussionThese dimensions of the menisci might be the major factors that determine the location and the kind of injury to menisci.

CORRELATION OF TIBIAL MENISCUS WITH TIBIAL PLATEAU AND ITS CLINICAL SIGNIFICANCE: A CADAVERIC STUDY

Conclusion: It can be easily judged that a graft which is too small in the size to fit the desired knee joint can be trapped beneath the condyles of femur. This might result in early damage to it due to disproportionate pressure acting on small meniscus. Whereas a large meniscus to a knee joint which is loose in fitting could also turn out to be ineffective due to disproportionate pressure distribution. Present Anthropometric study provides quantitative formulae to determine the meniscal dimensions, which may help to design artificial meniscus prostheses.

Mesure des allogreffes méniscales par microtomographies radiographiques

BackgroundX-ray microcomputed tomography (XMT) is a technique widely used to image hard and soft tissues. Meniscal allografts as collagen structures can be imaged and analyzed using XMT. The aim of this study was to present an XMT scanning protocol that can be used to obtain the 3D geometry of menisci. It was further applied to compare two methods of meniscal allograft measurement: traditional (based on manual measurement) and novel (based on digital measurement of 3D models of menisci obtained with use of XMT scanner). HypothesisThe XMT-based menisci measurement is a reliable method for assessing the geometry of a meniscal allograft by measuring the basic meniscal dimensions known from traditional protocol. Materials and methodsThirteen dissected menisci were measured according to the same principles traditionally applied in a tissue bank. Next, the same specimens were scanned by a laboratory scanner in the XMT lab. The images were processed to obtain a 3D mesh. Three-dimensional models of allograft geometry were then measured using a novel protocol enhanced by computer software. Then, both measurements were compared using statistical tests. ResultsThe results showed significant differences (P<0.05) between the lengths of the medial and lateral menisci measured in the tissue bank and the XMT Lab. Also, medial meniscal widths were significantly different (P<0.05). DiscussionDifferences in meniscal lengths may result from difficulties in dissected meniscus measurements in tissue banks, and may be related to the elastic structure of the dissected meniscus. Errors may also be caused by the lack of highlighted landmarks on the meniscal surface in this study. ConclusionThe XMT may be a good technique for assessing meniscal dimensions without actually touching the specimen. Level of evidenceLevel IV.

X-ray microtomography-based measurements of meniscal allografts

BackgroundX-ray microcomputed tomography (XMT) is a technique widely used to image hard and soft tissues. Meniscal allografts as collagen structures can be imaged and analyzed using XMT. The aim of this study was to present an XMT scanning protocol that can be used to obtain the 3D geometry of menisci. It was further applied to compare two methods of meniscal allograft measurement: traditional (based on manual measurement) and novel (based on digital measurement of 3D models of menisci obtained with use of XMT scanner). HypothesisThe XMT-based menisci measurement is a reliable method for assessing the geometry of a meniscal allograft by measuring the basic meniscal dimensions known from traditional protocol. Materials and methodsThirteen dissected menisci were measured according the same principles traditionally applied in a tissue bank. Next, the same specimens were scanned by a laboratory scanner in the XMT Lab. The images were processed to obtain a 3D mesh. 3D models of allograft geometry were then measured using a novel protocol enhanced by computer software. Then, both measurements were compared using statistical tests. ResultsThe results showed significant differences (P<0.05) between the lengths of the medial and lateral menisci measured in the tissue bank and the XMT Lab. Also, medial meniscal widths were significantly different (P<0.05). DiscussionDifferences in meniscal lengths may result from difficulties in dissected meniscus measurements in tissue banks, and may be related to the elastic structure of the dissected meniscus. Errors may also be caused by the lack of highlighted landmarks on the meniscal surface in this study. ConclusionThe XMT may be a good technique for assessing meniscal dimensions without actually touching the specimen. Level of evidenceLevel IV.

English

The morphometrical data related to the menisci of the adults have been reported by few authors but data specific to the population of East Goadavari region have not been reported. The aims of the present study were to analyse the external circumference thickness, the width, peripheral and inner border lengths, and the distance between anterior and posterior horns of the menisci and to compare them with those which are available in the literature. The menisci from 100 knee joints of the formalin fixed cadavers which were obtained from the Anatomy department of Rangaraya Medical College, Kakinada and Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram were analysed. The cadavers which had musculoskeletal anomalies were excluded from the study. A vernier calliper of 0.02 mm accuracy and a non-elastic cotton thread were used for the morphometry. After comparing the meniscal dimensions of the present study with the other available literature, we established that there are some morphological differences of meniscus in this set of population.

Is Radiographic Measurement of Bony Landmarks Reliable for Lateral Meniscal Sizing?

Background: The accuracy of meniscal measurement methods is still in debate. Hypothesis: The authors’ protocol for radiologic measurements will provide reproducible bony landmarks, and this measurement method of the lateral tibial plateau will correlate with the actual anatomic value. Study Design: Controlled laboratory study. Methods: Twenty-five samples of fresh lateral meniscus with attached proximal tibia were obtained during total knee arthroplasty. Each sample was obtained without damage to the meniscus and bony attachment sites. The inclusion criterion was mild to moderate osteoarthritis in patients with mechanical axis deviation of less than 15°. Knees with lateral compartment osteoarthritic change or injured or degenerated menisci were excluded. For the lateral tibial plateau length measurements, the radiographic beam was angled 10° caudally at neutral rotation, which allowed differentiation of the lateral plateau cortical margins from the medial plateau. The transition points were identified and used for length measurement. The values of length were then compared with the conventional Pollard method and the anatomic values. The width measurement was done according to Pollard’s protocol. For each knee, the percentage deviation from the anatomic dimension was recorded. Intraobserver error and interobserver error were calculated. Results: The deviation of the authors’ radiographic length measurements from anatomic dimensions was 1.4 ± 1.1 mm. The deviation of Pollard’s radiographic length measurements was 4.1 ± 2.0 mm. With respect to accuracy—which represents the frequency of measurements that fall within 10% of measurements—the accuracy of authors’ length was 98%, whereas for Pollard’s method it was 40%. There was a good correlation between anatomic meniscal dimensions and each radiologic plateau dimensions for lateral meniscal width (R 2 = .790) and the authors’ lateral meniscal length (R 2 = .823) and fair correlation for Pollard’s lateral meniscal length (R 2 = .660). The reliability of each radiologic measurement showed good reliability (intraclass correlation coefficients, .823 to .973). The authors tried to determine the best-fit equation for predicting meniscal size from Pollard’s method of bone size, as follows: anatomic length = 0.52 × plateau length (according to Pollard’s method) + 5.2, not as Pollard suggested (0.7 × Pollard’s plateau length). Based on this equation—namely, the modified Pollard method—the percentage difference decreased, and the accuracy increased to 92%. Conclusion: Lateral meniscal length dimension can be accurately predicted from the authors’ radiographic tibial plateau measurements. Clinical Relevance: This study may provide valuable information in preoperative sizing of lateral meniscus in meniscal allograft transplantation.