{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:34:31Z","timestamp":1777685671685,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2010,12,11]],"date-time":"2010-12-11T00:00:00Z","timestamp":1292025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Excessive varus and valgus stress forces during arthroscopy might exceed minimal compressive strength of cancellous bone. In extreme cases, this could lead to post\u2010arthroscopic osteonecrosis. It was our purpose to measure the valgus and varus stress forces during arthroscopy and draw conclusions on the development of osteonecrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>On 24 consecutive patients undergoing arthroscopy, the maximum varus and valgus stress forces (<jats:italic>N<\/jats:italic>) were measured in vivo using a strain gauge mounted to a leg holder. The forces (<jats:italic>N<\/jats:italic>) and contact stresses (kPa) on the femoral condyles were calculated based on the measured acting lateral force at the femur fixation based on the lever principle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The maximum contact stress during varus on the medial condyle was significantly lower in patients with intact meniscus (mean \u00b1 standard error of the mean: 243 \u00b1 29 kPa) than in patients with meniscus\u2010deficient knees (520 \u00b1 61 kPa; <jats:italic>P<\/jats:italic> &lt; 0.01). A similar finding was obtained for the maximum contact stress during valgus on the lateral condyle: 630 \u00b1 72 kPa in patients with intact meniscus compared to 2,173 \u00b1 159 kPa in patients with meniscus\u2010deficient knees (<jats:italic>P<\/jats:italic> &lt; 0.01). In 19 patients (79%), the maximum contact stress was higher during valgus than during varus. The maximum contact stress on the lateral condyle during valgus was significantly higher for more experienced surgeons (<jats:italic>P<\/jats:italic> = 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The maximum contact stresses in knees with intact menisci did not exceed the critical threshold of the compressive strength in cancellous bone. However, the maximum contact stresses in meniscus\u2010deficient knees were frequently higher than the threshold. However, these stresses were much lower than those during daily activities and therefore unlikely to lead to post\u2010arthroscopic osteonecrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Diagnostic study, Level II.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-010-1346-3","type":"journal-article","created":{"date-parts":[[2010,12,10]],"date-time":"2010-12-10T15:36:34Z","timestamp":1291995394000},"page":"747-752","source":"Crossref","is-referenced-by-count":7,"title":["Intra\u2010operative femoral condylar stress during arthroscopy: an in vivo biomechanical assessment"],"prefix":"10.1002","volume":"19","author":[{"given":"Rahel B.","family":"Schmid","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Bruderholz 4101 Bruderholz Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dieter","family":"Wirz","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Laboratory Of Biomechanics &amp; Biocalorimetry (LOB2) Basel University Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beat","family":"G\u00f6pfert","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Laboratory Of Biomechanics &amp; Biocalorimetry (LOB2) Basel University Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus P.","family":"Arnold","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Bruderholz 4101 Bruderholz Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niklaus F.","family":"Friederich","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Bruderholz 4101 Bruderholz Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael T.","family":"Hirschmann","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Bruderholz 4101 Bruderholz Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,12,11]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.65B5.6643563"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780110602"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00533"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198607000-00007"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453678008990887"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0268\u20100033(00)00013\u20109"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.06.1208"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/1758-2555-2-24"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010009\u20100879\u20109"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.79B1.6978"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-39209"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198870030-00027"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00445"},{"key":"e_1_2_7_15_2","first-page":"38","article-title":"Characterization and pathological characteristics of spontaneous osteonecrosis of the knee","volume":"29","author":"Mears SC","year":"2009","journal-title":"Iowa Orthop J"},{"key":"e_1_2_7_16_2","first-page":"1058","article-title":"Knee and shoulder arthroscopy. 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