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Medial and lateral meniscus have a different role in kinematics of the ACL-deficient knee: a systematic review
  1. Alberto Grassi1,
  2. Giacomo Dal Fabbro1,
  3. Stefano Di Paolo1,
  4. Federico Stefanelli1,
  5. Luca Macchiarola1,
  6. Gian Andrea Lucidi1,
  7. Stefano Zaffagnini1,2
  1. 1 II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  2. 2 Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM, Università degli Studi di Bologna, Bologna, Italy
  1. Correspondence to Dr Giacomo Dal Fabbro, II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna 40136, Italy; giacomo.dalfabbro{at}


Importance Meniscal tears are frequently associated with anterior cruciate ligament (ACL) injury and the correct management of this kind of lesion during ACL-reconstruction procedure is critical for the restoration of knee kinematics. Although the importance of meniscus in knee biomechanics is generally accepted, the influence of medial and lateral meniscus in stability of ACL-deficient knee is still unclear.

Objective The aim of this study was to review literature, which analysed effects in cadaveric specimens of meniscal tear and meniscectomy of medial and lateral meniscus on laxity in the ACL-deficient knee.

Evidence review Authors performed a systematic search for cadaveric studies analysing the effect of medial and lateral meniscus tears or resection on kinematics of ACL-deficient knee. Extracted data included year of publications, number of human cadaver knee specimens, description of apparatus testing and instrumented kinematic evaluation, testing protocol and results.

Findings Authors identified 18 studies that met inclusion and exclusion criteria of current review. The major finding of the review was that the works included reported a difference role of medial and lateral meniscus in restraining ACL-deficient knee laxity. Medial meniscus tear or resection resulted in a significant increase of anterior tibial displacement. Lateral meniscus lesions or meniscectomy on the other hand significantly increased rotation and translation under a coupled valgus stress and internal-rotation torque/pivot shift test.

Conclusions Medial and lateral meniscus have a different role in stabilising the ACL-deficient knee: while the medial meniscus functions as a critical secondary stabilisers of anterior tibial translation under an anterior/posterior load, lateral meniscus appears to be a more important restraint of rotational and dynamic laxity.

Level of evidence Level IV, systematic review of level I–IV studies.

  • meniscus
  • knee
  • biomechanics
  • instability
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  • Contributors AG and GDF contributed planning the work, performing the search, to analysis and elaboration of data and writing manuscript and tables. SZ planned and conducted the work and reviewed the manuscript. SDP contributed to planning the work and to analysis and elaboration of data. FS, LM and GAL contributed to planning the work and to drafting and revising it critically.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. All data relevant to the study are included in the article or uploaded as supplementary information.

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