Cyclic testing of 3 all-inside meniscal repair devices: a biomechanical analysis.
BACKGROUND
Despite the growing popularity of all-inside meniscal repair devices, concerns remain about their fixation strength. It is also unclear which of these devices have the most ideal biomechanical properties.


OBJECTIVE
To compare the biomechanical properties of 3 all-inside meniscal repair devices: the Meniscal Cinch, Ultra FAST-FIX, and MaxFire.


METHODS
Controlled laboratory study.


METHODS
Twenty-seven human cadaveric menisci (3 groups of 9) were repaired using 3 different meniscal repair devices. The repaired menisci were then subjected to cyclic loading and load-to-failure testing. Gap formation and ultimate load to failure were measured.


RESULTS
Six of the devices failed during cyclic testing, 4 in the MaxFire group (44%), 1 in the Ultra FAST-FIX group (11%), and 1 in the Meniscal Cinch group (11%). After 1 cycle, there was a trend toward larger gap formation in the MaxFire group (3.65 mm) compared with the Meniscal Cinch group (2.12 mm, P = .05). After 100 cycles, group differences were found in gap formation (P = .03), with the MaxFire group exhibiting greater displacement (6.70 mm) than the Ultra FAST-FIX group (3.59 mm). After 500 cycles, group differences in gap formation (Meniscal Cinch, 5.94; Ultra FAST-FIX, 4.74 mm; Max Fire, 7.19 mm) did not reach statistical significance (P = .20). A trend was found toward higher ultimate load to failure in the Ultra FAST-FIX (86.1 N) and Meniscal Cinch (85.3 N) groups compared with the MaxFire group (64.5 N, P = .06). Stiffness was also higher in the Ultra FAST-FIX (25.2 N/mm) and Meniscal Cinch (25.5 N/mm) groups than the MaxFire group (16.3 N/mm, P = .02).


CONCLUSIONS
The Meniscal Cinch and Ultra FAST-FIX devices have more desirable biomechanical properties than the MaxFire as demonstrated by higher stiffness and a lower failure rate during cyclic testing.


CONCLUSIONS
The Meniscal Cinch and Ultra FAST-FIX devices may be more desirable implants for use during all-inside meniscal repair as they have superior biomechanical properties when compared with the MaxFire device.
Fox Valley Orthopaedic Institute, 2525 Kaneville Road, Geneva, IL 60134, USA. vmehta@fvortho.com
Vishal M
VM
Mehta
Michael A
MA
Terry
D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D019544:Equipment Failure Analysis; D006801:Humans; D016268:Internal Fixators / Q000592:standards*; D008592:Menisci, Tibial / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000592:standards*; D000070600:Tibial Meniscus Injuries; D016474:Weight-Bearing; D055815:Young Adult