title: Tibiofemoral contact pressures in radial tears of the meniscus treated with all-inside repair, inside-out repair and partial meniscectomy.
abstract: BACKGROUND
  To test contact pressures in the knee after treatment of a radial meniscus tear with an all-inside meniscal repair technique and compare the results with inside-out repair and partial meniscectomy.
  
  
  METHODS
  Six non-paired cadaveric knees were analyzed with intra-compartment pressures measured at loads of 250 N, 500 N and 1000 N at 0°, eight degrees, 15°, and 30° of knee flexion. Compartmental contact pressures were measured for the intact medial meniscus, radial tear in the posterior horn, all-inside repair using the NovoStitch suture passer device (Ceterix Orthopaedics Inc., Menlo Park, CA), inside-out repair method, and partial meniscectomy. One-way ANOVA was used for statistical analysis.
  
  
  RESULTS
  The greatest differences in peak pressures between treatments were observed under 1000 N load at 30° flexion (0.8± (SD) 0.1 MPa (intact meniscus), 0.8± (SD) 0.1 MPa (all-inside), 0.9± (SD) 0.1 MPa (inside-out) and 1.6± (SD) 0.2 MPa (partial meniscectomy)). Treatment with partial meniscectomy resulted in the highest peak pressures compared to all other states (p<0.0001 at each angle). Repair of the radial tear using the all-inside technique as well as the inside-out technique resulted in significantly decreased compartment pressures compared to partial meniscectomies (p<0.0001 at each angle). There were no significant differences between peak pressures in the intact state and after repair with the all-inside or inside-out techniques.
  
  
  CONCLUSIONS
  An all-inside repair technique using the NovoStitch suture passer can decrease contact pressures for a radial meniscus tear similarly to the inside-out repair technique when compared to partial meniscectomy.
  
  
  CONCLUSIONS
  This novel arthroscopic suture passer warrants further analysis in the clinical setting as it may be a reliable method for repair of radial meniscal tears through an arthroscopic all-inside technique.
authors.affiliation: Department of Orthopaedic Surgery, University of California - San Francisco, San Francisco, CA, United States. Electronic address: Alan.Zhang@ucsf.edu.
authors.forename: Alan L
authors.initials: AL
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, University of California - San Francisco, San Francisco, CA, United States.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Miller
authors.affiliation: Department of Orthopaedic Surgery, University of California - San Francisco, San Francisco, CA, United States.
authors.forename: Dezba G
authors.initials: DG
authors.lastname: Coughlin
authors.affiliation: Department of Orthopaedic Surgery, University of California - San Francisco, San Francisco, CA, United States.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Lotz
authors.affiliation: Department of Orthopaedic Surgery, University of California - San Francisco, San Francisco, CA, United States.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Feeley
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000295:instrumentation / Q000379:methods*; D001696:Biomechanical Phenomena / Q000502:physiology; D002102:Cadaver; D005260:Female; D005269:Femur / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D011312:Pressure; D013977:Tibia / Q000503:physiopathology; D000070600:Tibial Meniscus Injuries
keywords: All-inside repair; Biomechanical analysis; Inside-out repair; NovoStitch suture passer; Radial meniscus tear