The Triad of Varus Malalignment, Meniscectomy, and Chondral Damage: A Biomechanical Explanation for Joint Degeneration

This biomechanical study evaluates the effect of varus malalalignment on knees with a chondral defect, both pre- and post-medial meniscectomy. Eight fresh-frozen cadaveric knees were first loaded physiologically. The knees were next loaded in increasing increments of varus. This loading cycle then was repeated after a chondral defect had been created, both pre- and post-medial meniscectomy. We found that a relatively small degree of varus malalignment caused a dramatic alteration in articular surface contact pressure and medial compartment loading, especially in the presence of chondral damage and/or medial meniscectomy. These findings may have important implications relating to the treatment of younger individuals with varus knees who have sustained meniscal and/or chondral damage.