title: Biomechanical evaluation of an all-inside suture-based device for repairing longitudinal meniscal tears.
abstract: OBJECTIVE
  A device for all-inside suture-based meniscal repairs has been introduced (NovoStitch; Ceterix, Menlo Park, CA) that passes the suture vertically through the meniscus, thereby encircling the tear, and does not require an additional incision or extra-capsular anchors. Our aim was to compare this all-inside suture-based repair with an inside-out suture repair and an all-inside anchor-based repair (FasT-Fix 360°; Smith & Nephew, Andover, MA).
  
  
  METHODS
  Longitudinal tears were created in 36 fresh-frozen porcine menisci. Repairs were performed using an all-inside suture-based meniscal repair device, an all-inside anchor-based repair, and an inside-out suture repair. They were tested with cyclic loading and load-to-failure testing. The displacement, response to cyclic loading (100, 300, and 500 cycles), and mode of failure were recorded. The stiffness of the constructs was calculated as well.
  
  
  RESULTS
  The all-inside suture-based repairs and the inside-out repairs showed significantly higher loads to failure than the all-inside anchor-based repairs. The stiffness values for the 3 repairs were not different. There were no differences in initial displacement. After 100, 300, and 500 cycles, the inside-out repair had higher gap formation (displacement) than the other 2 groups. Suture failure was the predominant mode of failure across all repair techniques.
  
  
  CONCLUSIONS
  The all-inside suture-based repairs and inside-out repairs did not exhibit different load-to-failure values. In addition, the all-inside suture-based repairs and the all-inside anchor-based repairs did not exhibit different displacement values during cyclic loading.
  
  
  CONCLUSIONS
  When addressing a longitudinal meniscal tear, surgeons should consider biomechanical data of various repair devices and techniques in their decision-making process to maximize the mechanical strength and healing probability of the repair.
authors.affiliation: Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Aidin
authors.initials: A
authors.lastname: Masoudi
authors.affiliation: Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Brandon S
authors.initials: BS
authors.lastname: Beamer
authors.affiliation: Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Ethan R
authors.initials: ER
authors.lastname: Harlow
authors.affiliation: Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Ohan S
authors.initials: OS
authors.lastname: Manoukian
authors.affiliation: Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Kempland C
authors.initials: KC
authors.lastname: Walley
authors.affiliation: Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hertz
authors.affiliation: Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Claudia
authors.initials: C
authors.lastname: Haeussler
authors.affiliation: Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Olson
authors.affiliation: Department of Anesthesiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.; Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: David
authors.initials: D
authors.lastname: Zurakowski
authors.affiliation: Center for Advanced Orthopaedic Studies, Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Ara
authors.initials: A
authors.lastname: Nazarian
authors.affiliation: Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Arun J
authors.initials: AJ
authors.lastname: Ramappa
authors.affiliation: Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.. Electronic address: jpdeange@bidmc.harvard.edu.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: DeAngelis
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D004195:Disease Models, Animal; D005260:Female; D008592:Menisci, Tibial / Q000503:physiopathology / Q000601:surgery*; D013314:Stress, Mechanical; D013536:Suture Techniques / Q000295:instrumentation*; D013552:Swine; D000070600:Tibial Meniscus Injuries