New suture method for radial tears of the meniscus: biomechanical analysis of cross-suture and double horizontal suture techniques using cyclic load testing.
BACKGROUND
Repair of complete radial meniscal tears is a key to restoring the mechanical integrity necessary to maintain hoop tension in the meniscus. The primary stability of the meniscal repair is one of the most important factors for meniscal healing, but the biomechanical structural properties of different repair techniques for complete radial meniscal tears remain unknown.


OBJECTIVE
Our novel cross-suture technique with suturing oblique to the collagen fibrils of the meniscus will yield better fixation than the standard double horizontal suture technique with suturing parallel to the collagen fibrils in the meniscus.


METHODS
Controlled laboratory study.


METHODS
Biomechanical investigation was performed on 40 fresh human menisci (2 groups of 20 menisci each) from patients who underwent total knee arthroplasty. In the cross-suture technique group (group A), the sutures crossed over 5 mm from the tear and 5 mm and 10 mm from the rim. In the double horizontal suture technique group (group B), the sutures were parallel and had the same attachment points as group A. The specimens were cyclically loaded 500 times between 5 and 30 N and then loaded to failure after completion of the cyclic load testing.


RESULTS
Compared with the double horizontal suture group, the cross-suture group had a significantly higher ultimate failure load (78.96 ± 19.27 N vs 68.16 ± 12.92 N; P < .05), significantly greater stiffness (8.01 ± 1.54 N/mm vs 6.46 ± 1.12 N/mm; P < .05), and significantly lower displacement (5.74 ± 1.84 mm vs 8.56 ± 2.39 mm; P < .05) after a 500-cycle loading protocol.


CONCLUSIONS
Our cross-suture technique significantly improved the structural properties of the repaired complete radial meniscal tears.


CONCLUSIONS
The cross-suture technique for repair of radial meniscal tears provides high stability and could be a promising solution in young and in active patients.
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Hirokazu
H
Matsubara
Ken
K
Okazaki
Toshiaki
T
Izawa
Yasutaka
Y
Tashiro
Shuichi
S
Matsuda
Takuya
T
Nishimura
Yoshitaka
Y
Nakanishi
Hideya
H
Kawamura
Yukihide
Y
Iwamoto
D001696:Biomechanical Phenomena; D006801:Humans; D066298:In Vitro Techniques; D007718:Knee Injuries / Q000601:surgery*; D008592:Menisci, Tibial / Q000502:physiology / Q000601:surgery*; D013314:Stress, Mechanical; D013536:Suture Techniques; D000070600:Tibial Meniscus Injuries; D016474:Weight-Bearing