Biomechanik des Meniskus

Die Hauptfunktion der knorpeligen Menisken des Kniegelenks ist die Reduzierung des Druckes auf den femoralen und tibialen Gelenkflächen. Die biomechanische Funktion der Menisken wird durch ihre spezielle Anatomie und ihren ultrastrukturellen Aufbau gewährleistet. Daneben kommt auch den meniskotibialen Bändern eine entscheidende Bedeutung zu.

Meniskusverletzungen machen häufig Teil- oder – seltener – die Totalresektion eines Meniskus erforderlich. Dies führt zur signifikanten Erhöhung des Kontaktdruckes und in der Folge nicht selten zu Gelenkarthrose.

Um die Funktionsweise des Meniskus und die Auswirkungen von Verletzungen und operativen Eingriffen auf die Kniegelenkmechanik zu verstehen, ist ein Grundverständnis des anatomischen Aufbaus und der biomechanischen Funktionsweise des Meniskus sowie seiner Materialeigenschaften erforderlich. Dieser Artikel soll dem Orthopäden und Unfallchirurgen einen Überblick über die biomechanische Funktionsweise des Meniskus und seiner operativen Behandlung geben.

• Quellenangaben

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• Zum Weiterlesen und Vertiefen

• 1 Andrews S, Shrive N, Ronsky J. The shocking truth about meniscus. J Biomech 2011; 44: 2737-2740
• 2 Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med 1982; 10: 90-95
• 3 Beaufils P, Verdonk R. The Meniscus. Heidelberg: Springer; 2010
• 4 Fithian DC, Kelly MA, Mow VC. Material properties and structure-function relationships in the menisci. Clin Orthop Relat Res 1990; 252: 19-31
• 5 Lee SJ, Aadalen KJ, Malaviya P et al. Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med 2006; 34: 1334-1344
• 6 Masouros SD, McDermott ID, Amis AA et al. Biomechanics of the meniscus-meniscal ligament construct of the knee. Knee Surg Sports Traumatol Arthrosc 2008; 16: 1121-1132
• 7 McDermott ID, Masouros SD, Amis AA. Biomechanics of the menisci of the knee. Current Orthop 2008; 22: 193-201
• 8 Mow VC, Huiskes R. Basic orthopaedic Biomechanics and Mechano-Biology. 3rd. ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005
• 9 Petersen W, Tillmann B. Funktionelle Anatomie der Menisken des Kniegelenks Kollagenfasertextur und Biomechanik. Arthroskopie 1998; 11: 133-135
• 10 Vedi V, Williams A, Tennant SJ et al. Meniscal movement. An in-vivo study using dynamic MRI. J Bone Joint Surg Br 1999; 81: 37-41
• 11 Vrancken AC, Buma P, van Tienen TG. Synthetic meniscus replacement: a review. Int Orthop 2013; 37: 291-299