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Document Title: Rankin-AJSM-Jul02.shtml
Article Title: A Biomechanical Analysis of Meniscal Repair Techniques
Authors: Christopher C. Rankin, MD, David M. Lintner, MD, Philip C. Noble, PhD, Vibor Paravic and Erin Greer, MD
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date:
Volume 30, pages 492-497
Keywords: Meniscal repair, suturing, arrows, barbs, comparison, bovine (cow) model.
(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)
Comments: This study, involving bovine menisci, compares the biomechanics of the various repair techniques. It found that suturing provides the strongest results. Other studies have also shown suturing to be superior to arrows (not only in strength but also in terms of success).
ABSTRACT
Background: Various methods are available for repair of meniscal tears: a biodegradable meniscal implant without sutures (Biofix meniscus arrow), a suture anchor device (T-fix), and horizontal and vertical mattress sutures.
Hypothesis: There is no difference in repair strength or mode of failure among the techniques compared.
Study Design: Controlled laboratory study.
Methods: Reproducible tears were created in bovine menisci and repaired with each of the techniques. Residual displacement of the tear immediately after repair and the resistance to displacement under load applied perpendicular to the tear were measured and compared.
Results: The residual displacement after repair was highest in the Biofix arrow group (0.70 mm) and lowest in the vertical mattress suture group (0.21 mm). The ultimate strength of repair was strongest for the vertical sutures (202 ± 7 N) and lowest for the arrow and T-fix (95.9 ± 8 N and 99.4 ± 8 N, respectively). The force required to generate 2 mm of tear displacement was greatest for the vertical sutures (143 N) and least for the arrow (43.6 N).
Conclusions: Suture techniques were stronger at all levels of testing.
Clinical Relevance: Knowledge of biomechanical characteristics aids the surgeon in choosing the appropriate technique for each situation.
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