Vascular risk associated with meniscal repair using Rapidloc versus FasT-Fix: comparison of two all-inside meniscal devices.
Eight fresh-frozen cadaver legs (average age 72 years) were used to evaluate the risk to the popliteal artery related to the use of two all-inside meniscal repair devices, the Mitek RapidLoc (12.5 mumudegrees) and the Smith & Nephew FasT-Fix (curved). The lumen of the femoral artery was injected with barium. Anteroposterior (AP) and lateral radiographs were obtained to ensure visualization of the popliteal artery and its anatomic location. Both devices were inserted into the posterior horn of the lateral meniscus up to the hub of the needle under direct arthroscopic visualization. The distance between the needle and the artery was measured on the radiographs using calipers. The average distance from the needle to the popliteal artery was 0.5 mm (0.5 +/- 0.8 mm, range: 0-2 mm) on the lateral radiograph and 6.0 mm (6.0 +/- 6.2 mm, range: 0-19 mm) on the AP radiograph using the FasT-Fix system without the penetration limiter. None of the RapidLoc needles were within 20 mm of the popliteal artery on either of the radiographs. The FasT-Fix device came within 3 mm of the artery on both AP and lateral radiographs in 43% of the specimens. The risk to the popliteal artery was significantly greater using the FasT-Fix device compared to the RapidLoc device (P < .05). Although both instruments appear safe when used properly, the RapidLoc device seems to be safer with less risk to the popliteal artery than the current FasT-Fix meniscal repair device. When using the FasT-Fix device, the penetration limiter must be used to avoid the complications found in this study.
Department of Orthopedic Surgery, University of Pittsburgh Medical Center; Pittsburgh, Pa, USA.
Steven B
SB
Cohen
Lucy
L
Boyd
Mark D
MD
Miller
D020341:Absorbable Implants; D000368:Aged; D001182:Arthroscopy; D002102:Cadaver; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D009339:Needles; D011150:Popliteal Artery / Q000000981:diagnostic imaging*; D011859:Radiography; D013536:Suture Techniques / Q000295:instrumentation*