Increased meniscal loading after anterior cruciate ligament transection in vivo: A longitudinal study in sheep

IntroductionMeniscal injury has been well documented as a frequent consequence of both acute and chronic ACL deficiency. The purpose of this study was to evaluate the effect of ACL deficiency on meniscal loads in vivo and determine how these loads would change over time after ACL injury.MethodsThe in vivo kinematics of the stifle joint of five sheep were measured during normal gait, as well as 4 and 20 weeks after ACL transection. A unique robotic testing platform was then programmed to reproduce all the previously recorded kinematics and the loads carried by medial and lateral menisci during gait were estimated.ResultsThe results demonstrated a significant increase in both medial and lateral meniscal loads 20 weeks following ACL transection, mainly during mid-stance phase of gait (p = 0.007 and p = 0.003, respectively), with interesting inter-subject variability. A moderate correlation (R2 ≥ 0.5) between in situ meniscal loads and anterior tibial translations was also detected over time after injury, increased translations post injury generally corresponded to larger meniscal loads.ConclusionThe dramatic increase in meniscal loads long term post ACL transection probably explains the meniscal changes or injuries reported clinically in many chronic ACL-deficient knees. Level of evidence: III.