{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:43:16Z","timestamp":1793994196049,"version":"4.8.0"},"reference-count":60,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2024,9,15]],"date-time":"2024-09-15T00:00:00Z","timestamp":1726358400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"deutsche forschungsgemeinschaft","doi-asserted-by":"publisher","award":["493624047!"],"award-info":[{"award-number":["493624047!"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Supported by \u201cInnovative Medizinische Forschung\u201d - Medical Faculty M\u00c3nster","award":["DE222209"],"award-info":[{"award-number":["DE222209"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In addition to the integrity of the meniscal hoop function, both the anterior and posterior meniscus roots as well as the meniscotibial and meniscofemoral ligaments are crucial in restraining meniscal extrusion. However, the interaction and load sharing between the roots and these peripheral attachments (PAs) are not known.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purposes:<\/jats:title>\n                    <jats:p>To investigate the influence of an insufficiency of the PAs on the forces acting on a posterior medial meniscus root repair (PMMRR) in both neutral and varus alignment and to explore whether meniscal centralization reduces these forces.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Controlled laboratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In 8 fresh-frozen human cadaveric knees, an arthroscopic transosseous root repair (step 1) was performed after sectioning the posterior root of the medial meniscus. The pull-out suture was connected to a load cell to allow measurement of the forces acting on the root repair. A medial closing-wedge distal femoral osteotomy was performed to change the mechanical axis from neutral to 5\u00b0 of varus alignment. The meniscus was completely released from its PAs (step 2), followed by transosseous arthroscopic centralization (step 3). Each step was tested in both neutral and varus alignment. The specimens were subjected to nondestructive dynamic varus loading under axial compression of 300 N in 0\u00b0, 15\u00b0, 30\u00b0, 45\u00b0, and 60\u00b0 flexion. The changes in force acting on the PMMRR were statistically analyzed using a mixed linear model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Axial loading in neutral alignment led to an increase of the force of root repair of 3.1 \u00b1 3.1 N (in 0\u00b0 flexion) to 6.3 \u00b1 4.4 N (in 60\u00b0 flexion). In varus alignment, forces increased significantly from 30\u00b0 (3.5 N; 95% CI, 1.1-5.8 N; P = .01) to 60\u00b0 (7.1 N; 95% CI, 2.7-11.5 N; P = .007) flexion, in comparison with neutral alignment. Cutting of the PAs in neutral alignment led to a significant increase of root repair forces in all flexion angles, from 7.0 N (95% CI, 1.0-13.0 N; P = .02) to 9.1 N (95% CI, 4.1-14.1 N; P = .003), in comparison with the intact state. Varus alignment significantly increased the forces in the cut states from 4.8 N (95% CI, 1.0-8.5 N; P = .02) to 11.1 N (95% CI, 4.2-18.0 N; P = .006) from 30\u00b0 to 60\u00b0 flexion, in comparison with the neutral alignment. Arthroscopic centralization led to restoration of the native forces in both neutral and varus alignment, with no significant differences between the centralized and intact states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>An insufficiency of the PAs of the medial meniscus, as well as varus alignment, led to increased forces acting on a PMMRR. These forces were reduced via an arthroscopic meniscal centralization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>Performing arthroscopic meniscal centralization concomitantly with PMMRR may reduce failure of the repair by reducing the load of the root.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465241274791","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T07:25:36Z","timestamp":1726557936000},"page":"3030-3038","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Arthroscopic Centralization of the Medial Meniscus Reduces Load on a Posterior Root Repair Under Dynamic Varus Loading: A Biomechanical Investigation"],"prefix":"10.1177","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1643-5992","authenticated-orcid":false,"given":"Adrian","family":"Deichsel","sequence":"first","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery, University Hospital M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Peez","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery, University Hospital M\u00fcnster, M\u00fcnster, Germany"},{"name":"AO Research Institute Davos, Davos, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Raschke","sequence":"additional","affiliation":[{"name":"Department of Trauma, Hand and Reconstructive Surgery, University Hospital M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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