TY - JOUR
T1 - THE EFFECTS OF POSTERIOR TIBIAL MOBILIZATION ON MENISCAL MOVEMENT
T2 - AN IN-SITU INVESTIGATION
AU - Scd, Susan Lilly P.T.
AU - Seeber, Gesine H.
AU - Smith, Michael P.
AU - McGaugh, Janna M.
AU - Roger James, C.
AU - Brismée, Jean Michel
AU - Sizer, Phillip S.
N1 - Publisher Copyright:
© 2019, North American Sports Medicine Institute. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Background: Anterior knee pain during knee extension may be related to a meniscal movement restriction and increased menis-cal load during function. One method of treatment involves the use of manual posterior mobilization of the tibia to specifically target the meniscotibial interface of the knee joint. Purpose: The purpose of this study was to measure motion at a cadaveric medial meniscus anterior horn during a posterior tibial mobilization. Study Design: Prospective, multifactorial, repeated–measures laboratory study. Methods: Eight unembalmed cadaveric knee specimens were mounted in a custom apparatus and markers were placed in the medial meniscus, tibia and femur. The tibia was posteriorly mobilized in two randomized knee positions (0 degrees and 25 degrees) using three randomly assigned loads (44.48N, 88.96N, and 177.93N). Markers were photographed and digitally measured and analyzed. Results: All load x position conditions produced anterior displacement of the meniscus on the tibia, where the displacement was significant [t (7) =-3.299; p = 0.013] at 0 degrees loaded with 177.93N (mean 0.41±0.35 mm). The results of 2(position) x 3(load) repeated measures ANOVA for meniscotibial displacement produced no significant main effects for load [F (2,14) = 2.542; p = 0.114) or position [F (1,7) = 0.324, p= 0.587]. All load x position conditions produced significant posterior tibial and meniscal displacement on the femur. The 2(position) x 3(load) repeated measures ANOVA revealed a significant main effect for load for both femoral marker displacement relative to the tibial axis [F (2,14) = 77.994; p < 0.001] and meniscal marker displacement relative to the femoral marker [F (2,14) = 83.620; p < 0.001]. Conclusion: Use of a mobilization technique to target the meniscotibial interface appears to move the meniscus anteriorly on the tibia. It appears that this technique may be most effective at the end range position. Level of Evidence: 2 (laboratory study).
AB - Background: Anterior knee pain during knee extension may be related to a meniscal movement restriction and increased menis-cal load during function. One method of treatment involves the use of manual posterior mobilization of the tibia to specifically target the meniscotibial interface of the knee joint. Purpose: The purpose of this study was to measure motion at a cadaveric medial meniscus anterior horn during a posterior tibial mobilization. Study Design: Prospective, multifactorial, repeated–measures laboratory study. Methods: Eight unembalmed cadaveric knee specimens were mounted in a custom apparatus and markers were placed in the medial meniscus, tibia and femur. The tibia was posteriorly mobilized in two randomized knee positions (0 degrees and 25 degrees) using three randomly assigned loads (44.48N, 88.96N, and 177.93N). Markers were photographed and digitally measured and analyzed. Results: All load x position conditions produced anterior displacement of the meniscus on the tibia, where the displacement was significant [t (7) =-3.299; p = 0.013] at 0 degrees loaded with 177.93N (mean 0.41±0.35 mm). The results of 2(position) x 3(load) repeated measures ANOVA for meniscotibial displacement produced no significant main effects for load [F (2,14) = 2.542; p = 0.114) or position [F (1,7) = 0.324, p= 0.587]. All load x position conditions produced significant posterior tibial and meniscal displacement on the femur. The 2(position) x 3(load) repeated measures ANOVA revealed a significant main effect for load for both femoral marker displacement relative to the tibial axis [F (2,14) = 77.994; p < 0.001] and meniscal marker displacement relative to the femoral marker [F (2,14) = 83.620; p < 0.001]. Conclusion: Use of a mobilization technique to target the meniscotibial interface appears to move the meniscus anteriorly on the tibia. It appears that this technique may be most effective at the end range position. Level of Evidence: 2 (laboratory study).
KW - Anterior knee pain
KW - Knee
KW - Meniscus
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U2 - 10.26603/ijspt20190032
DO - 10.26603/ijspt20190032
M3 - Article
AN - SCOPUS:85160585665
SN - 2159-2896
VL - 14
SP - 32
EP - 45
JO - International Journal of Sports Physical Therapy
JF - International Journal of Sports Physical Therapy
IS - 1
ER -