title: Biomechanical comparison of arthroscopic repair constructs for radial tears of the meniscus.
abstract: BACKGROUND
  Radial tears of the meniscus represent a challenging clinical scenario because benign neglect and partial meniscectomy have both been shown to have negative biomechanical and long-term clinical consequences.
  
  
  OBJECTIVE
  Complex suture repair constructs have higher failure loads and stiffness values compared with simple constructs.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  After radial transection of human cadaveric menisci, simulated tears were repaired arthroscopically by use of 1 of 4 repair constructs: (1) 2 inside-out horizontal sutures, (2) 2 all-inside horizontal sutures, (3) an all-inside Mason-Allen construct consisting of 4 sutures, or (4) an all-inside construct consisting of a figure-of-8 suture plus 1 horizontal suture. Meniscus specimens were harvested and tested to failure on an Instron machine. The Kruskal-Wallis test was used to evaluate for significance of maximal failure load and stiffness between groups.
  
  
  RESULTS
  The mean maximum failure loads were 64 ± 20 N (inside-out horizontal construct), 75 ± 16 N (all-inside horizontal construct), 86 ± 19 N (Mason-Allen construct), and 113 ± 22 N (figure-of-8 plus horizontal construct). Interconstruct comparison revealed a statistically significant difference between the figure-of-8 plus horizontal construct and all 3 remaining constructs (P < .02) as well as the Mason-Allen construct when compared with the inside-out horizontal construct (P < .01). Statistical significance was not found between the all-inside horizontal construct and the Mason-Allen construct or between the all-inside horizontal construct and the inside-out horizontal construct (P = .2 and .7, respectively). Stiffness values were lower for the inside-out construct compared with the all-inside constructs (P < .05).
  
  
  CONCLUSIONS
  Complex all-inside repair constructs had significantly higher failure loads than a conventional, simple inside-out suture repair construct for repair of radial meniscal tears. Stiffness values among the all-inside groups were greater than those for the inside-out group.
  
  
  CONCLUSIONS
  Arthroscopic techniques are presented to produce stronger radial meniscal tear repairs.
authors.affiliation: Andrews Research and Education Institute, Gulf Breeze, Florida, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Branch
authors.affiliation: Andrews Research and Education Institute, Gulf Breeze, Florida, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Milchteim
authors.affiliation: Andrews Research and Education Institute, Gulf Breeze, Florida, USA.
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Aspey
authors.affiliation: Department of Kinesiology, College of Education, Auburn University, Auburn, Alabama, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Cedars-Sinai Orthopaedic Center, Los Angeles, California, USA.
authors.forename: Justin D
authors.initials: JD
authors.lastname: Saliman
authors.affiliation: Andrews Research and Education Institute, Gulf Breeze, Florida, USA anz.adam.w@gmail.com.
authors.forename: Adam W
authors.initials: AW
authors.lastname: Anz
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena / Q000502:physiology; D002102:Cadaver; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D022125:Lacerations / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D012421:Rupture / Q000503:physiopathology / Q000601:surgery; D013312:Stress, Physiological / Q000502:physiology; D013536:Suture Techniques; D013537:Sutures; D000070600:Tibial Meniscus Injuries; D014945:Wound Healing / Q000502:physiology
keywords: failure load; meniscus; radial tear; repair