Forward lunge knee biomechanics before and after partial meniscectomy

Abstract

Background: Patients following meniscectomy are at increased risk of developing knee osteoarthritis in the tibiofemoral compartment and at the patellofemoral joint. As osteoarthritis is widely considered a mechanical disease, it is important to understand the potential effect of arthroscopic partial meniscectomy (APM) on knee joint mechanics. The purpose of this study was to evaluate changes in knee joint biomechanics during a forward lunge in patients with a suspected degenerative meniscal tear from before to three months after APM.

Methods: Twenty-two patients (35-55 years old) with a suspected degenerative medial meniscal tear participated in this study. Three dimensional knee biomechanics were assessed on the injured and contralateral leg before and three months after APM. The visual analogue scale was used to assess knee pain and the Knee Injury Osteoarthritis Outcome Score was used to assess sport/recreation function and knee-related confidence before and after APM.

Results: The external peak knee flexion moment reduced in the APM leg compared to the contralateral leg (mean difference (95% CI)) -1.08 (-1.80 to -0.35) (Nm/(BW × HT)%), p = 0.004. Peak knee flexion angle also reduced in the APM leg compared to the contralateral leg -3.94 (-6.27 to -1.60) degrees, p = 0.001. There was no change in knee pain between the APM leg and contralateral leg (p=0.118). Self-reported sport/recreation function improved (p = 0.004).

Conclusions: Although patients self-reported less difficulty during strenuous tasks following APM, patients used less knee flexion, a strategy that may limit excessive patellar loads during forward lunge in the recently operated leg.

Keywords: Degenerative tear; Knee biomechanics; Osteoarthritis; Rehabilitation exercise.