title: Biomechanical investigations of different meniscal repair implants in comparison with horizontal sutures on human meniscus.
abstract: OBJECTIVE
  The use of biodegradable implants for arthroscopic repair of meniscal lesions is becoming increasingly popular. The aim of this study was to test the biomechanical stability and the mode of failure of these implants.
  
  
  METHODS
  Biomechanical testing study.
  
  
  METHODS
  Biomechanical investigations were performed on human menisci using 6 commonly used biodegradable implants for meniscal repair to compare them with horizontal mattress suture using 2/0 Ethibond (Ethicon, Norderstedt, Germany). Included in this study were the Meniscus Arrow (Bionx, Tampere, Finland), Dart (Arthrex, Naples, FL), Stinger (Linvatec, Largo, FL), Meniscal Screw (Innovasive, Marlborough, MA), T-Fix (Acufex, Mansfield, MA), and the Fastener (Mitek, Westwood, MA). The tests were carried out using a material testing machine at a loading rate of 10 N/second. The ultimate tension load (UTL), elongation, and stiffness were evaluated for each implant technique.
  
  
  RESULTS
  The highest UTL was shown by Ethibond (62 +/- 7.91 N) and the T-Fix (51.35 +/- 16.31 N), followed by the Fastener (32.67 +/- 2.97 N). All other implants had a significantly lower UTL (P =.001). Less elongation under a load of 5 N was noted for Ethibond (0.64 +/- 0.25 mm) and for T-Fix (0.43 +/- 0.32 mm) compared with the other implants. The greatest elongation was found for the Fastener (2.239 +/- 0.581 mm). The stiffness of the fixation was similar in all implants, except for the Dart and Fastener, which were significantly inferior (P <.05).
  
  
  CONCLUSIONS
  All of the biodegradable implants had lower UTL than the suture techniques. Therefore, when using the implants, they should be inserted close together to provide sufficient stability. In cases of an extended lesion, there might even be an option to combine the implant and suturing techniques.
authors.affiliation: Department of Orthopaedic Surgery, Otto von Guericke University, Magdeburg, Germany. roland.becker@medizin-uni-magdeburg.de
authors.forename: R
authors.initials: R
authors.lastname: Becker
authors.forename: M
authors.initials: M
authors.lastname: Schröder
authors.forename: C
authors.initials: C
authors.lastname: Stärke
authors.forename: D
authors.initials: D
authors.lastname: Urbach
authors.forename: W
authors.initials: W
authors.lastname: Nebelung
mesh_terms: D020341:Absorbable Implants; D001182:Arthroscopy; D001696:Biomechanical Phenomena; D004548:Elasticity; D019544:Equipment Failure Analysis; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008422:Materials Testing; D008592:Menisci, Tibial / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D011091:Polyesters; D011126:Polypropylenes; D013536:Suture Techniques; D000070600:Tibial Meniscus Injuries; D016474:Weight-Bearing
chemical_list: D011091:Polyesters; D011126:Polypropylenes; C033616:poly(lactide)