{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T22:39:38Z","timestamp":1779230378145,"version":"3.51.4"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"07","funder":[{"name":"The Assistant Secretary of Defense for Health Affairs","award":["W81XWH-18-1-0430"],"award-info":[{"award-number":["W81XWH-18-1-0430"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Medial meniscotibial ligament (MTL) lesions may go unrecognized and untreated and have detrimental impact on knee biomechanics and joint pathology. Therefore, this study was designed to compare the biomechanical impact of midbody MTL disruption to corresponding peripheral medial meniscal (PMM) tears in anterior cruciate ligament (ACL) intact and ACL-deficient cadaveric knees. Cadaveric knees (n\u2009=\u200912; 6 matched pairs) were tested for laxity and ACL strain under anterior, valgus, and external rotation loading at 0, 30, and 90 degree of flexion. Knees were randomly assigned to ACL-intact (n\u2009=\u20096) or ACL-deficient (n\u2009=\u20096) groups. Large midbody MTL disruption or corresponding PMM tears were created (n\u2009=\u20093\/group) and knees retested. PMM tears were repaired arthroscopically with inside-out suturing, and MTL lesions were repaired with suture anchors via an open approach. Knees were retested after repair. Biomechanical testing data were compared for statistically significant differences. Large MTL and PMM lesions were associated with significant increases in ACL strain, anterior laxity at 0, 30, and 90 degrees (p\u2009=\u20090.006), valgus laxity (p\u2009=\u20090.0012), and external rotation laxity (p\u2009=\u20090.0003) compared with intact knees. Repair of each lesion restored knee stability and reduced ACL strain to intact levels. In ACL-deficient knees, there was significantly increased anterior, valgus, and external rotation laxity compared with the ACL-intact state and MTL and PMM lesions further increased laxity at all angles. However, differences were not statistically significant and repair of meniscal lesions alone did not restore stability to ACL-deficient knees. These results highlight the need to recognize medial MTL injury and perform an appropriate repair procedure to restore knee stability and protect against excessive ACL strain.<\/jats:p>","DOI":"10.1055\/s-0039-3402483","type":"journal-article","created":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T00:11:41Z","timestamp":1578528701000},"page":"784-792","source":"Crossref","is-referenced-by-count":15,"title":["Impact of Medial Meniscotibial Ligament Disruption Compared to Peripheral Medial Meniscal Tear on Knee Biomechanics"],"prefix":"10.1055","volume":"34","author":[{"given":"Patrick A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri"},{"name":"Columbia Orthopaedic Group, Columbia, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph L.","family":"Humpherys","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri"},{"name":"Department of Orthopaedic Surgery and Sports Medicine, Regional Health Orthopedic & Specialty Hospital, Rapid City, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P.","family":"Stannard","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri"},{"name":"Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James L.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri"},{"name":"Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,1,8]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.jsams.2008.07.005","article-title":"Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study","volume":"12","author":"S M Gianotti","year":"2009","journal-title":"J Sci Med Sport"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1249\/MSS.0b013e318277acca","article-title":"Epidemiology of knee injuries among U.S. high school athletes, 2005\/2006-2010\/2011","volume":"45","author":"D M Swenson","year":"2013","journal-title":"Med Sci Sports Exerc"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1177\/0363546510388933","article-title":"Arthroscopic prevalence of ramp lesion in 868 patients with anterior cruciate ligament injury","volume":"39","author":"X Liu","year":"2011","journal-title":"Am J Sports Med"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1177\/0363546515574061","article-title":"Incidence of secondary intra-articular injuries with time to anterior cruciate ligament reconstruction","volume":"43","author":"S Ralles","year":"2015","journal-title":"Am J Sports Med"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1177\/0363546503261738","article-title":"The posteromedial corner of the knee: medial-sided injury patterns revisited","volume":"32","author":"W F Sims","year":"2004","journal-title":"Am J Sports Med"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1177\/03635465010290040501","article-title":"Medial and lateral meniscal tear patterns in anterior cruciate ligament-deficient knees. 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