An anatomically shaped medial meniscus prosthesis is able to partially restore the contact mechanics of the meniscectomized knee joint

Abstract

Purpose: The aim of this study was to determine whether a flexible medial meniscus prosthesis is more capable of sharing loads with the direct tibiofemoral cartilage contact than the stiffer first-generation prosthesis. Additionally, the effect of the prosthesis on the tibial pressure distribution after total meniscectomy was investigated. Methods: In an artificial knee joint, the relative amounts of load transferred through both meniscus prostheses and the direct tibiofemoral contact were assessed with pressure-sensitive sensors. Additionally, six cadaveric knee joints were loaded in a physiological environment. Tibial contact pressures were measured with an intact native meniscus, after total meniscectomy and after implantation of the second-generation meniscus prosthesis. Results: Whereas the first generation of the meniscus prosthesis transferred virtually all the load from femur to tibia, the second-generation prosthesis allowed for load sharing with the direct tibiofemoral contact. No differences in load sharing were found between the native meniscus and the second-generation meniscus prosthesis. The prosthesis decreased peak and mean pressures on the medial tibial cartilage compared to meniscectomy. No significant differences in pressure were found between the native meniscus and the meniscus prosthesis. Conclusions: The second-generation meniscus prosthesis presented in this study can share loads with the direct tibiofemoral contact, a characteristic that the first-generation prosthesis did not have. The flexible meniscus prosthesis significantly reduces the contact pressures on the medial tibial plateau after total meniscectomy. Although the biomechanical performance of the native meniscus could not be reproduced completely, the meniscus prosthesis may have the potential to relieve post-meniscectomy pain symptoms.