ANALYSIS OF GAIT AND KNEE FUNCTION PRIOR TO AND AFTER MENISCUS RESECTION

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Abstract

Background. Injuries of meniscus are the frequent lesions in the knee joint (KJ). A big number of false-positive and false-negative outcomes may mislead not only a patient but also a specialist in traumatology and orthopedics. Functional and biomechanical studies of the knee joint might provide additional data for clinical decision making and diagnostics.

Materials and Methods. The authors studied 47 patients with traumatic and degenerative tears of the KJ meniscus. All patients were divided into 3 groups. Group I included 10 patients analyzed before and after the arthroscopic treatment, Group II included 22 patients analyzed before treatment only and Group III included 15 patients analyzed after the surgical treatment only. The authors studied the gait biomechanics as well as hip and knee function. In Group I the time from disease onset to the surgical treatment was 9.7 months. The grade on the KOOS scale was 29.4 points before the treatment and 80.2 points after the treatment. In Group II, the grade was 34.2 points. In Group III, the grade was 85.6 point.

Results. The temporal characteristics of the gait cycle did not exhibit any differences from the normal state in all the groups. In Group I a statistically significant increase of the hip extension amplitude was observed, both for the operated and the intact leg. In Groups II and III the authors did not observe this pattern. The abduction-adduction and rotation motions in the hip did not exhibit any significant changes in all the three groups. In Group I knee joint kinematics at the affected side did not differ from intact leg prior to the treatment. After the surgery the value of magnitude phase during the basic knee flexion at the operated side significantly decreased. The amplitude itself increased, but the difference did not reach a statistical significance due to high data dispersion. Patients of Group II and III also demonstrated significant difference in the phase of basic flexion with the same value on the intact side. The abduction-adduction motions were decreased at the intact side after the surgery in the first group.

Conclusion. Thus, the meniscus injury results in slight disorder in the walking and biomechanics of the knee which are successfully compensated during one year after arthroscopic treatment.

About the authors

D. V. Skvortsov

Pirogov Russian National Research Medical University;
Federal Scientific Clinical Center of FMBA of Russia

Author for correspondence.
Email: skvortsov.biom@gmail.com

Dr. Sci. (Med.), Professor, Department of Rehabilitation, Sports Medicine and Physical Education

Head of the Center of Sports Medicine and Rehabilitation

1, ul. Ostrovityanova, Moscow, 117997

28, Orekhovyi bul’var, Moscow, 115682

Russian Federation

S. N. Kaurkin

Pirogov Russian National Research Medical University;
Federal Scientific Clinical Center of FMBA of Russia

Email: fake@neicon.ru

Assistant, Department of Medical Rehabilitation

Cand. Sci. (Med.), Senior Researcher, Center of Sports Medicine and Rehabilitation

1, ul. Ostrovityanova, Moscow, 117997

28, Orekhovyi bul’var, Moscow, 115682

Russian Federation

A. A. Akhpashev

Federal Scientific Clinical Center of FMBA of Russia;
Peoples’ Friendship University of Russia

Email: fake@neicon.ru

Orthopedic Surgeon

Cand. Sci. (Med.), Associate professor

28, Orekhovyi bul’var, Moscow, 115682

6, Miklukho-Maklaya, Moscow, 117198

Russian Federation

N. V. Zagorodny

Peoples’ Friendship University of Russia

Email: fake@neicon.ru

Dr. Sci. (Med.), Professor, correspondent member of Russian Academy of Sciences, Chief of Traumatology and Orthopedic Chair

6, Miklukho-Maklaya, Moscow, 117198

Russian Federation

D. S. Agzamov

Federal Scientific Clinical Center of FMBA of Russia

Email: fake@neicon.ru

Dr. Sci. (Med.), Head of Traumatology and Orthopedic Department

28, Orekhovyi bul’var, Moscow, 115682

Russian Federation

References

  1. Hede A., Jensen D.B., Blyme P., Sonne-Holm S. Epidemiology of meniscal lesions in the knee. Acta Orthop Scand. 1990;61(5):435-437. doi: 10.3109/17453679008993557.
  2. De Smet A.A., Nathan D.H., Graf B.K., Haaland B.A., Fine J.P. Clinical and MRI findings associated with falsepositive knee MR diagnoses of medial meniscal tears. AJR Am J Roentgenol. 2008;191(1):93-99. doi: 10.2214/ajr.07.3034.
  3. Bolog N.V., Andreisek G. Reporting knee meniscal tears: technical aspects, typical pitfalls and how to avoid them. Insights Imaging. 2016;7(3):385-398. doi: 10.1007/s13244-016-0472-y.
  4. Noble J., Hamblen D.L. The pathology of the degenerate meniscus lesion. J Bone Joint Surg Br. 1975;57(2):180-186. doi: 10.1002/bjs.1800621213.
  5. Berthiaume M.J., Raynauld J.P., Martel-Pelletier J., Labonté F., Beaudoin G., Bloch D.A. et al. Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis. 2005;64(4):556-563. doi: 10.1136/ard.2004.023796.
  6. Strobel M.J. Manual of Arthroscopic Surgery. New York: Springer; 1988. pp. 171-178.
  7. Bollen S.R. Posteromedial meniscocapsular injury associated with rupture of the anterior cruciate ligament: a previously unrecognized association. J Bone Joint Surg Br. 2010;92(2):222-223. doi: 10.1302/0301-620x.92b2.22974.
  8. Sonnery-Cottet B., Conteduca J., Thaunat M., Xavier F., Seil G., Seil R. Hidden Lesions of the Posterior Horn of the Medial Meniscus: A Systematic Arthroscopic Exploration of the Concealed Portion of the Knee. Am J Sports Med. 2014;42(4):921-692. doi: 10.1177/0363546514522394.
  9. Fairbank T.J. Knee joint changes after meniscectomy. J Bone Joint Surg Br. 1948;30B(4):664-670.
  10. Jørgensen U., Sonne-Holm S., Lauridsen F., Rosenklint A. Long-term follow-up of meniscectomy in athletes. J Bone Joint Surg. 1987;69(1):80-83.
  11. Englund M. Meniscal tear--a feature of osteoarthritis. Acta Orthop Scand. Suppl. 2004;75(312):1-45. doi: 10.1080/746571764.
  12. Noyes F.R., Chen R.C., Barber-Westin S.D., Potter H.G. Greater than 10- year results of red-white longitudinal meniscal repairs in patients 20 years of age or younger. Am J Sports Med. 2011;39(5):1008-1017. doi: 10.1177/0363546510392014.
  13. Eberbach H., Zwingmann J., Hohloch L., Bode G., Maier D., Niemeyer P. et al. Sport-specific outcomes after isolated meniscal repair: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2017 Feb 27. doi: 10.1007/s00167-017-4463-4.
  14. Edd S.N., Netravali N.A., Favre J., Giori N.J., Andriacchi T.P. Alterations in knee kinematics after partial medial meniscectomy are activity dependent. Am J Sports Med. 2015;43(6):1399-407. doi: 10.1177/0363546515577360.
  15. Dempsey A.R., Wang Y., Thorlund J.B., Mills .PM., Wrigley T.V., Bennell K.L. et al. The relationship between patellofemoral and tibiofemoral morphology and gait biomechanics following arthroscopic partial medial meniscectomy. Knee Surg Sports Traumatol Arthrosc. 2013;21(5):1097-1103. doi: 10.1007/s00167-012-2075-6.
  16. Harato K., Sakurai A., Kudo Y., Nagura T., Masumoto K., Otani T., Niki Y. Three-dimensional knee kinematics in patients with a discoid lateral meniscus during gait. Knee. 2016;23(4):622-666. doi: 10.1016/j.knee.2015.10.007.
  17. Magyar O.M., Illyés A., Knoll Z., Kiss R.M. Effect of medial meniscectomy on gait parameters. Knee Surg Sports Traumatol Arthrosc. 2008;16(4):427-433. doi: 10.1007/s00167-007-0430-9.
  18. Magyar M.O., Knoll Z., Kiss R.M. The influence of medial meniscus injury and meniscectomy on the variability of gait parameters. Knee Surg Sports Traumatol Arthrosc. 2012;20(2):290-297. doi: 10.1007/s00167-011-1612-z.
  19. Sturnieks D.L., Besier T.F., Mills P.M., Ackland T.R., Maguire K.F., Stachowiak G.W., Podsiadlo P., Lloyd D.G. Knee joint biomechanics following arthroscopic partial meniscectomy. J Orthop Res. 2008;26(8):1075-1080. doi: 10.1002/jor.20610.
  20. Roos E.M., Roos H.P., Lohmander L.S., Ekdahl C., Beynnon B.D. Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998;28(2):88-96. doi: 10.2519/jospt.1998.28.2.88.
  21. Ахпашев А.А., Загородний Н.В., Канаев А.С., Кауркин С.Н., Скворцов Д.В. Функция коленного сустава во время ходьбы у больных с разрывом передней крестообразной связки коленного сустава до и после оперативного лечения. Травматология и ортопедия России. 2016;(2):15-24. doi: 10.21823/2311-2905-2016-0-2-15-24. Akhpashev A.A., Zagorodnii N.V., Kanaev A.S., Kaurkin S.N., Skvortsov D.V. [Knee joint gait function in patients with ACL rupture before and after the surgery.] Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2016;(2):15-24. (in Russian). doi: 10.21823/2311-2905-2016-0-2-15-24.
  22. Chatain F., Adeleine P., Chambat P., Neyret P. Société Française d’Arthroscopie. A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-year minimum follow-up. Arthroscopy. 2003;19(8):842-849.
  23. Mariani P.P., Garofalo R., Margheritini F. Chondrolysis after partial menisectomy in athletes. Knee Surg Sports Traumatol Arthrosc. 2008;16(6):574-580. doi: 10.1007/s00167-008-0508-z.
  24. van de Graaf V.A., Wolterbeek N., Scholtes V.A., Mutsaerts E.L., Poolman R.W. Reliability and validity of the IKDC, KOOS, and WOMAC for patients with meniscal injuries. Am J Sports Med. 2014;42(6):1408-1416. doi: 10.1177/0363546514524698.
  25. Herrlin S.V., Peter O. Wange P.O., Lapidus G., Hallander M., Werner S., Weidenhielm L. Is arthroscopic surgery beneficial in treating non-traumatic, degenerative medial meniscal tears? A five year follow-up. Knee Surg Sports Traumatol Arthrosc. 2013;21(2):358-364. doi: 10.1007/s00167-012-1960-3.
  26. Katz J.N., Brophy R.H., Chaisson C.E., de Chaves L., Cole B.J., Dahm D.L. et al. Surgery versus physical therapy for a meniscal tear and osteoarthritis. N Engl J Med. 2013;368:1675-1684. doi: 10.1056/NEJMoa1301408.
  27. Goldberg S.R., Stanhope S.J. Sensitivity of joint moments to changes in walking speed and body-weight-support are interdependent and vary across joints. J Biomech. 2013;46(6):1176-1183. doi: 10.1016/j.jbiomech.2013.01.001.
  28. Kerrigan C.D., Lee L.W., Collins J.J., Riley P.O., Lipsitz L.A. Reduced Hip Extension During Walking: Healthy Elderly and Fallers Versus Young Adults. Arch Phys Med Rehabil. 2001;82(1):26-30. doi: 10.1053/apmr.2001.18584.
  29. Lewis C.L., Sahrmann S.A., Moran D.W. Effect of hip angle on anterior hip joint force during gait. Gait Posture. 2010;32(4):603-607. doi: 10.1016/j.gaitpost.2010.09.001.
  30. Zhang L.Q., Wang G. Dynamic and static control of the human knee joint in abduction-adduction. J Biomech. 2001; 34(9):1107-1115. doi: 10.1016/s0021-9290(01)00080-x.

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