Benefit of single-leaf resection for horizontal meniscus tear

Abstract

When treating a horizontal meniscus tear, the surgeon must decide whether to resect one or both leaves of the tear. We asked whether there is a biomechanical advantage to sparing one leaf when performing a partial meniscectomy for horizontal meniscus tear. We used pressure-sensitive film to measure the contact area, mean pressure, and peak pressure on the lateral tibial plateau of cadaveric sheep knees loaded to 2x body weight. For tears restricted to the posterior third, single-leaf resection decreased contact area by 40% compared with the intact case. Sparing one leaf was beneficial because resection of the second leaf reduced contact area an additional 15%. Similarly, mean pressure was increased 24% for single-leaf resection and an additional 27% for double-leaf resection. Peak pressure showed no differences with single- and double-leaf resections. For tears that span the entire meniscus, single-leaf resection reduced contact area by 59%, increased mean pressure by 55%, and increased peak pressure by 19%. Double-leaf resection in this situation did not change these values substantially, suggesting sparing one leaf offers no benefit over resecting both leaves with extensive horizontal meniscus tears.