Identification of Cross-Sectional Parameters of Lateral Meniscal Allografts That Predict Tibial Contact Pressure in Human Cadaveric Knees

Abstract

To guide the development of improved procedures for selecting meniscal allografts, the objective of this study was to identify which cross-sectional parameters of a lateral meniscal allograft predict the contact pressure of the articular surface of the tibia. To meet the objective, the contact pressure of the articular surface of the tibia was measured with a lateral meniscal autograft and a lateral meniscal allograft using pressure sensitive film in 15 fresh-frozen human cadaveric knees. Allografts were matched only in transverse dimensions to the autograft but not in cross-sectional dimensions. Knees were loaded to 1200 N in compression at flexion angles of 0, 15, 30 and 45 degrees using a load application system that allowed unconstrained motion in the remaining degrees of freedom. Five cross-sectional parameters for both of the grafts in each of the anterior, middle, and posterior regions were derived from measurements obtained using a laser-based non-contacting three-dimensional coordinate digitizing system (3-DCDS) (Haut et al., J. Orthop Res, 2000). Five contact variables (i.e. the maximum pressure, mean pressure, contact area, and anterior-posterior and medial-lateral locations of the centroid of contact area) were determined from the pressure sensitive film. When each allograft was paired with the corresponding autograft, the root mean squared percent differences for the cross-sectional parameters ranged from a minimum of 28% for the width of the posterior region to 572% for the height of the posterior region. The root mean squared percent differences between the contact variables for paired grafts were 29% for the maximum pressure, 19% for the mean pressure, and 24% for the contact area. Differences in the cross-sectional parameters between the grafts were related to differences in the contact variables using regression analysis. Difference in the width was most often a predictor variable in the regression models with R2 values ≥0.45. Differences in all of the four remaining cross-sectional parameters were also important predictor variables. Because failure to match cross-sectional parameters causes substantial difference in contact variables between an allograft and autograft and because cross-sectional parameters predict the contact pressure on the tibial plateau, protocols used to prospectively select allografts should concentrate on matching cross-sectional parameters and particularly the width to those of the original meniscus.