Meniscal repair using large diameter horizontal sutures increases fixation strength: an in vitro study.
OBJECTIVE
the purpose of this study was to compare the mechanical characteristics of meniscal repair fixation using horizontal sutures and two different diameter sutures under submaximal cyclic and load to failure test conditions.


METHODS
a 2-cm long anteroposterior vertical longitudinal incision was created in two groups of bovine medial menisci. Lesions were repaired using either #2-0 (Group 1), or #2 (Group 2) Fiberwire suture. Following repair, the lesion was extended through the posterior and anterior meniscal horns so that no tissue secured the repair site. Specimens underwent submaximal cyclic (5-50 N at 1 Hz for 500 cycles) and load to failure testing (5 mm/min crosshead speed) in a servo hydraulic device. Specimen failure mode was verified by the primary investigator. An alpha level of P < 0.05 was selected to indicate statistical significance.


RESULTS
group 2 displayed greater load at failure (132.1 ± 54.4 N) than Group 1 (91.9 ± 26.2 N) (P = 0.02). Group 2 also displayed greater stiffness (47.1 ± 8.3 N/mm) than Group 1 (38.5 ± 10.2 N/mm) (P = 0.03). The failure mode for all specimens was suture pull-through the meniscal tissue. Larger diameter suture provided superior mechanical meniscal fixation.


CONCLUSIONS
if horizontal suture would be used in meniscal repair, the most suitable larger diameter suture should be used.
Kocabey
Yavuz
Y
Department of Orthopaedics and Traumatalogy, Kocaeli Acıbadem Hospital, Kocaeli, Turkey. drkocabey@yahoo.com
Taşer
Omer
O
Hapa
Onur
O
Güçlü
Aycan
A
Bozdag
Ergun
E
Sünbüloglu
Emin
E
Doral
Mahmutnedim
M
D000818:Animals; D002417:Cattle; D004867:Equipment Design; D019544:Equipment Failure Analysis; D008422:Materials Testing; D008592:Menisci, Tibial / Q000601:surgery*; D013537:Sutures; D000070600:Tibial Meniscus Injuries