Biomechanical characteristics of lower limbs after discoid lateral meniscus injury surgery_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHOU Zirui ^1,2 , WANG Siqi ^1,2 , TIAN Xiaojing ³ , XU Bingbing ² , LEI Mingming ⁴ ,  WANG Jianquan ²

1. College of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, P. R. China;
2. Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, 100191, P. R. China;
3. Community Health Service Center of Anjing Street, Pidu District, Chengdu Sichuan, 611731, P. R. China;
4. Department of Sport Injury, Affiliated Sport Hospital to Chengdu Sport University, Chengdu Sport University, Chengdu Sichuan, 610041, P. R. China;

Corresponding?author：

WANG Jianquan, Email: wjqsportsmed@163.com

Keywords：

Discoid lateral meniscus; knee; biomechanics; surgical treatment; research progress

DOI：

10.7507/1002-1892.202504015

Video：

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Objective To review the research progress on the lower limb biomechanical characteristics of patients with discoid lateral meniscus (DLM) injury after surgery. Methods By searching relevant domestic and international research literature on DLM, the postoperative characteristics of knee joint movement biomechanics, tibiofemoral joint stress distribution, lower extremity force line, and patellofemoral joint changes in patients with DLM injury were summarized. Results Surgical treatment can lead to varying degrees of changes in the lower limb biomechanical characteristics of patients with DLM injury. Specifically, the kinematic biomechanics of the knee joint can significantly improve, but there are still problems such as extension deficits in the affected knee joint. The peak stress of the tibiofemoral joint decreases with the increase of the residual meniscus volume, and the degree of change is closely related to the residual meniscus volume. Preserving a larger volume of the meniscus, especially the anterior horn volume, helps to reduce stress concentration. The lower extremity force line will deviate outward after surgery, and the more meniscus is removed during surgery, the greater the change in the lower extremity force line after surgery. There are conditions such as cartilage degeneration, position and angle changes in the patellofemoral joint after surgery. Conclusion The changes in the lower limb biomechanical characteristics after DLM injury are closely related to the choice of surgical methods and rehabilitation programs. However, the mechanisms of biomechanical changes in multiple lower limb joints and individual differences still need to be further studied and clarified.

Citation： ZHOU Zirui, WANG Siqi, TIAN Xiaojing, XU Bingbing, LEI Mingming, WANG Jianquan. Biomechanical characteristics of lower limbs after discoid lateral meniscus injury surgery. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(7): 891-895. doi: 10.7507/1002-1892.202504015 Copy

1.	Saavedra M, Sepúlveda M, Jesús Tuca M, et al. Discoid meniscus: current concepts. EFORT Open Rev, 2020, 5(7): 371-379.
2.	Kocher MS, Logan CA, Kramer DE. Discoid lateral meniscus in children: diagnosis, management, and outcomes. J Am Acad Orthop Surg, 2017, 25(11): 736-743.
3.	Ogata Y, Tabuchi K, Kinouchi S, et al. Knee extension deficit during gait and knee extensor weakness persisting after saucerization and repair of discoid lateral meniscus tears. Knee, 2024, 47: 171-178.
4.	Sheasley JA, Kirby JC, Niu EL, et al. Characteristics and outcomes of operatively treated discoid lateral meniscus in pediatric and young adult patients: a multicenter study. Am J Sports Med, 2024, 52(11): 2758-2763.
5.	Furumatsu T, Maehara A, Okazaki Y, et al. Intercondylar and central regions of complete discoid lateral meniscus have different cell and matrix organizations. J Orthop Sci, 2018, 23(5): 811-818.
6.	Atay OA, Pekmezci M, Doral MN, et al. Discoid meniscus: an ultrastructural study with transmission electron microscopy. Am J Sports Med, 2007, 35(3): 475-478.
7.	代瑞蘭, 敖英芳. 前交叉韌帶重建術后運動生物力學特征. 科技導報, 2022, 40(2): 27-35.
8.	陸逸群, 吳悅, 劉振龍, 等. 前交叉韌帶斷裂及重建術后步態生物力學特征研究現狀. 北京大學學報(自然科學版), 2024, 60(2): 377-392.
9.	Harato K, Sakurai A, Kudo Y, et al. Three-dimensional knee kinematics in patients with a discoid lateral meniscus during gait. Knee, 2016, 23(4): 622-626.
10.	Li Y, Wu Y, Zeng Y, et al. Biomechanical differences before and after arthroscopic partial meniscectomy in patients with semilunar and discoid lateral meniscus injury. Am J Transl Res, 2020, 12(6): 2793-2804.
11.	Lin Z, Huang W, Ma L, et al. Kinematic features in patients with lateral discoid meniscus injury during walking. Sci Rep, 2018, 8(1): 5053. doi: 10.1038/s41598-018-22935-0.
12.	林澤楓, 張余, 馬立敏, 等. 外側盤狀半月板損傷患者膝關節在體運動學參數研究. 中國骨科臨床與基礎研究雜志, 2014, 6(5): 291-296.
13.	Nishino K, Koga H, Koga Y, et al. Association of isometric quadriceps strength with stride and knee kinematics during gait in community dwelling adults with normal knee or early radiographic knee osteoarthritis. Clin Biomech (Bristol), 2021, 84: 105325. doi: 10.1016/j.clinbiomech.2021.105325.
14.	葛永軍, 宣勇, 穆帥, 等. 膝關節盤狀半月板有限元模型的構建及生物力學分析. 中國矯形外科雜志, 2019, 27(22): 2071-2075.
15.	Lee SW, Chun YM, Choi CH, et al. Single-leaf partial meniscectomy in extensive horizontal tears of the discoid lateral meniscus: Does decreased peripheral meniscal thickness affect outcomes? (Mean four-year follow-up). Knee, 2016, 23(3): 472-477.
16.	Gamble JG, Abdalla AB, Meadows MG, et al. Radial width of the lateral meniscus at the popliteal hiatus: relevance to saucerization of discoid lateral menisci. Am J Sports Med, 2022, 50(1): 138-141.
17.	Liu W, Sun X, Liu W, et al. Finite element study of a partial meniscectomy of a complete discoid lateral meniscus in adults. Med Eng Phys, 2022, 107: 103855. doi: 10.1016/j.medengphy.2022.103855.
18.	Shen X, Lu M, Liu M, et al. Effect of residual volume after surgery of the discoid lateral meniscus on tibiofemoral joint biomechanics: a finite element analysis. J Orthop Surg Res, 2024, 19(1): 43. doi: 10.1186/s13018-023-04522-w.
19.	Yokoe T, Ouchi K, Matsumoto T, et al. Effect of the volume of resected discoid lateral meniscus on the contact stress of the tibiofemoral joint: A finite element analysis. Knee, 2023, 42: 57-63.
20.	傅德杰, 楊柳, 郭林. 半月板損傷與下肢力線. 中國矯形外科雜志, 2021, 29(4): 330-333.
21.	Kim SJ, Bae JH, Lim HC. Does torn discoid meniscus have effects on limb alignment and arthritic change in middle-aged patients? J Bone Joint Surg (Am), 2013, 95(22): 2008-2014.
22.	李光曦. 關節鏡下成形縫合術治療完全型盤狀半月板損傷的臨床觀察. 鄭州: 鄭州大學, 2013.
23.	史俊龍, 鹿戰, 雷宏偉, 等. 下肢力線在盤狀半月板損傷應用的研究進展. 中國骨傷, 2020, 33(4): 383-387.
24.	張普延. 關節鏡下外側盤狀半月板切除對下肢力線的影響. 合肥: 安徽醫科大學, 2018.
25.	王雪松, 陳雪, 王成成, 等. 關節鏡下外側盤狀半月板切除范圍對單側盤狀半月板損傷患者下肢力線及膝關節功能的影響. 新鄉醫學院學報, 2019, 36(7): 619-622.
26.	李明, 劉華, 章云峰, 等. 盤狀半月板切除術對中老年患者下肢力線的早期影響. 中國骨與關節損傷雜志, 2018, 33(6): 575-578.
27.	鄧岳. 膝關節鏡下半月板切除術對下肢力線影響的系統評價與META分析. 廈門: 廈門大學, 2019.
28.	王駿飛, 蔣青, 陳東陽, 等. 半月板切除對下肢力線的影響. 中華骨科雜志, 2005, 25(8): 481-484.
29.	Qiao Y, Zhang X, Wu C, et al. Prevalence and a correlation analysis of discoid meniscus and femoral trochlear dysplasia. BMC Musculoskelet Disord, 2023, 24(1): 923. doi: 10.1186/s12891-023-06958-x.
30.	Kuwabara A, Kraus E, Fredericson M. Narrative review—Knee pain in the pediatric athlete. Curr Rev Musculoskelet Med, 2021, 14(3): 239-245.
31.	Dong J, Xu H, Jin G, et al. The adaptive change of patellofemoral joint after arthroscopic discoid lateral meniscus plasty: An observational study. Medicine (Baltimore), 2018, 97(6): e9827. doi: 10.1097/MD.0000000000009827.
32.	Zhang Z, She C, Li L, et al. Mid-term study on the effects of arthroscopic discoid lateral meniscus plasty on patellofemoral joint: An observational study. Medicine (Baltimore), 2022, 101(45): e31760. doi: 10.1097/MD.0000000000031760.
33.	Chedal-Bornu B, Morin V, Saragaglia D. Meniscoplasty for lateral discoid meniscus tears: Long-term results of 14 cases. Orthop Traumatol Surg Res, 2015, 101(6): 699-702.
34.	Hall M, Wrigley TV, Metcalf BR, et al. A longitudinal study of strength and gait after arthroscopic partial meniscectomy. Med Sci Sports Exerc, 2013, 45(11): 2036-2043.
35.	Weber AE, Harris JD, Nho SJ. Complications in hip arthroscopy: A systematic review and strategies for prevention. Sports Med Arthrosc Rev, 2015, 23(4): 187-193.
36.	Fan ZY, Wang Y, Dong QR, et al. Lateral patellar translation effects after arthroscopic partial meniscectomy of torn discoid lateral meniscus. Orthop Surg, 2014, 6(1): 38-41.
37.	Wang J, Xiong J, Xu Z, et al. Short-term effects of discoid lateral meniscectomy on the axial alignment of the lower limb in adolescents. J Bone Joint Surg (Am), 2015, 97(3): 201-207.
38.	Ganderup T, Jensen C, Holsgaard-Larsen A, et al. Recovery of lower extremity muscle strength and functional performance in middle-aged patients undergoing arthroscopic partial meniscectomy. Knee Surg Sports Traumatol Arthrosc, 2017, 25(2): 347-354.

1. Saavedra M, Sepúlveda M, Jesús Tuca M, et al. Discoid meniscus: current concepts. EFORT Open Rev, 2020, 5(7): 371-379.
2. Kocher MS, Logan CA, Kramer DE. Discoid lateral meniscus in children: diagnosis, management, and outcomes. J Am Acad Orthop Surg, 2017, 25(11): 736-743.
3. Ogata Y, Tabuchi K, Kinouchi S, et al. Knee extension deficit during gait and knee extensor weakness persisting after saucerization and repair of discoid lateral meniscus tears. Knee, 2024, 47: 171-178.
4. Sheasley JA, Kirby JC, Niu EL, et al. Characteristics and outcomes of operatively treated discoid lateral meniscus in pediatric and young adult patients: a multicenter study. Am J Sports Med, 2024, 52(11): 2758-2763.
5. Furumatsu T, Maehara A, Okazaki Y, et al. Intercondylar and central regions of complete discoid lateral meniscus have different cell and matrix organizations. J Orthop Sci, 2018, 23(5): 811-818.
6. Atay OA, Pekmezci M, Doral MN, et al. Discoid meniscus: an ultrastructural study with transmission electron microscopy. Am J Sports Med, 2007, 35(3): 475-478.
7. 代瑞蘭, 敖英芳. 前交叉韌帶重建術后運動生物力學特征. 科技導報, 2022, 40(2): 27-35.
8. 陸逸群, 吳悅, 劉振龍, 等. 前交叉韌帶斷裂及重建術后步態生物力學特征研究現狀. 北京大學學報(自然科學版), 2024, 60(2): 377-392.
9. Harato K, Sakurai A, Kudo Y, et al. Three-dimensional knee kinematics in patients with a discoid lateral meniscus during gait. Knee, 2016, 23(4): 622-626.
10. Li Y, Wu Y, Zeng Y, et al. Biomechanical differences before and after arthroscopic partial meniscectomy in patients with semilunar and discoid lateral meniscus injury. Am J Transl Res, 2020, 12(6): 2793-2804.
11. Lin Z, Huang W, Ma L, et al. Kinematic features in patients with lateral discoid meniscus injury during walking. Sci Rep, 2018, 8(1): 5053. doi: 10.1038/s41598-018-22935-0.
12. 林澤楓, 張余, 馬立敏, 等. 外側盤狀半月板損傷患者膝關節在體運動學參數研究. 中國骨科臨床與基礎研究雜志, 2014, 6(5): 291-296.
13. Nishino K, Koga H, Koga Y, et al. Association of isometric quadriceps strength with stride and knee kinematics during gait in community dwelling adults with normal knee or early radiographic knee osteoarthritis. Clin Biomech (Bristol), 2021, 84: 105325. doi: 10.1016/j.clinbiomech.2021.105325.
14. 葛永軍, 宣勇, 穆帥, 等. 膝關節盤狀半月板有限元模型的構建及生物力學分析. 中國矯形外科雜志, 2019, 27(22): 2071-2075.
15. Lee SW, Chun YM, Choi CH, et al. Single-leaf partial meniscectomy in extensive horizontal tears of the discoid lateral meniscus: Does decreased peripheral meniscal thickness affect outcomes? (Mean four-year follow-up). Knee, 2016, 23(3): 472-477.
16. Gamble JG, Abdalla AB, Meadows MG, et al. Radial width of the lateral meniscus at the popliteal hiatus: relevance to saucerization of discoid lateral menisci. Am J Sports Med, 2022, 50(1): 138-141.
17. Liu W, Sun X, Liu W, et al. Finite element study of a partial meniscectomy of a complete discoid lateral meniscus in adults. Med Eng Phys, 2022, 107: 103855. doi: 10.1016/j.medengphy.2022.103855.
18. Shen X, Lu M, Liu M, et al. Effect of residual volume after surgery of the discoid lateral meniscus on tibiofemoral joint biomechanics: a finite element analysis. J Orthop Surg Res, 2024, 19(1): 43. doi: 10.1186/s13018-023-04522-w.
19. Yokoe T, Ouchi K, Matsumoto T, et al. Effect of the volume of resected discoid lateral meniscus on the contact stress of the tibiofemoral joint: A finite element analysis. Knee, 2023, 42: 57-63.
20. 傅德杰, 楊柳, 郭林. 半月板損傷與下肢力線. 中國矯形外科雜志, 2021, 29(4): 330-333.
21. Kim SJ, Bae JH, Lim HC. Does torn discoid meniscus have effects on limb alignment and arthritic change in middle-aged patients? J Bone Joint Surg (Am), 2013, 95(22): 2008-2014.
22. 李光曦. 關節鏡下成形縫合術治療完全型盤狀半月板損傷的臨床觀察. 鄭州: 鄭州大學, 2013.
23. 史俊龍, 鹿戰, 雷宏偉, 等. 下肢力線在盤狀半月板損傷應用的研究進展. 中國骨傷, 2020, 33(4): 383-387.
24. 張普延. 關節鏡下外側盤狀半月板切除對下肢力線的影響. 合肥: 安徽醫科大學, 2018.
25. 王雪松, 陳雪, 王成成, 等. 關節鏡下外側盤狀半月板切除范圍對單側盤狀半月板損傷患者下肢力線及膝關節功能的影響. 新鄉醫學院學報, 2019, 36(7): 619-622.
26. 李明, 劉華, 章云峰, 等. 盤狀半月板切除術對中老年患者下肢力線的早期影響. 中國骨與關節損傷雜志, 2018, 33(6): 575-578.
27. 鄧岳. 膝關節鏡下半月板切除術對下肢力線影響的系統評價與META分析. 廈門: 廈門大學, 2019.
28. 王駿飛, 蔣青, 陳東陽, 等. 半月板切除對下肢力線的影響. 中華骨科雜志, 2005, 25(8): 481-484.
29. Qiao Y, Zhang X, Wu C, et al. Prevalence and a correlation analysis of discoid meniscus and femoral trochlear dysplasia. BMC Musculoskelet Disord, 2023, 24(1): 923. doi: 10.1186/s12891-023-06958-x.
30. Kuwabara A, Kraus E, Fredericson M. Narrative review—Knee pain in the pediatric athlete. Curr Rev Musculoskelet Med, 2021, 14(3): 239-245.
31. Dong J, Xu H, Jin G, et al. The adaptive change of patellofemoral joint after arthroscopic discoid lateral meniscus plasty: An observational study. Medicine (Baltimore), 2018, 97(6): e9827. doi: 10.1097/MD.0000000000009827.
32. Zhang Z, She C, Li L, et al. Mid-term study on the effects of arthroscopic discoid lateral meniscus plasty on patellofemoral joint: An observational study. Medicine (Baltimore), 2022, 101(45): e31760. doi: 10.1097/MD.0000000000031760.
33. Chedal-Bornu B, Morin V, Saragaglia D. Meniscoplasty for lateral discoid meniscus tears: Long-term results of 14 cases. Orthop Traumatol Surg Res, 2015, 101(6): 699-702.
34. Hall M, Wrigley TV, Metcalf BR, et al. A longitudinal study of strength and gait after arthroscopic partial meniscectomy. Med Sci Sports Exerc, 2013, 45(11): 2036-2043.
35. Weber AE, Harris JD, Nho SJ. Complications in hip arthroscopy: A systematic review and strategies for prevention. Sports Med Arthrosc Rev, 2015, 23(4): 187-193.
36. Fan ZY, Wang Y, Dong QR, et al. Lateral patellar translation effects after arthroscopic partial meniscectomy of torn discoid lateral meniscus. Orthop Surg, 2014, 6(1): 38-41.
37. Wang J, Xiong J, Xu Z, et al. Short-term effects of discoid lateral meniscectomy on the axial alignment of the lower limb in adolescents. J Bone Joint Surg (Am), 2015, 97(3): 201-207.
38. Ganderup T, Jensen C, Holsgaard-Larsen A, et al. Recovery of lower extremity muscle strength and functional performance in middle-aged patients undergoing arthroscopic partial meniscectomy. Knee Surg Sports Traumatol Arthrosc, 2017, 25(2): 347-354.

Chinese Journal of Reparative and Reconstructive Surgery

Biomechanical characteristics of lower limbs after discoid lateral meniscus injury surgery

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