Skip to main content

Meniscal Repair: Biomechanics

  • Chapter
  • First Online:
The Meniscus

Abstract

In the medium and long term, meniscal repair has been shown to be successful in 70–80% of cases when performed for the right indications. Despite these excellent results, recent data from France showed that meniscal repair is only considered in a vast minority of meniscal surgeries, not exceeding the 3–5% limit [14]. Considering the high educational impact of the French Arthroscopic Society (SFA) among French surgeons, one can assume that this situation is comparable to other countries in Europe. These figures show that there is still room for improvement for meniscal repair, especially with respect to the constantly evolving surgical techniques, which are becoming less invasive, safer and easier to use by the surgical community. Furthermore, early clinical data have shown similar results as with the classical suture techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Albrecht-Olsen P, Lind T, Kristensen G, Falkenberg B (1997) Failure strength of a new meniscus arrow repair technique: biomechanical comparison with horizontal suture. Arthroscopy 13:183–187

    Article  CAS  PubMed  Google Scholar 

  2. Allaire R, Muriuki M, Gilbertson L, Harner CD (2008) Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am 90(9):1922–1931

    Article  PubMed  Google Scholar 

  3. Arnoczky SP, Lavagnino M (2001) Tensile fixation strengths of absorbable meniscal repair devices as a function of hydrolysis time. An in vitro experimental study. Am J Sports Med 29(2):118–123

    CAS  PubMed  Google Scholar 

  4. Asik M, Sener N, Akpinar S, Durmaz H, Göksan A (1997) Strength of different meniscus suturing techniques. Knee Surg Sports Traumatol Arthrosc 5:80–83

    Article  CAS  PubMed  Google Scholar 

  5. Asik M, Sener N (2002) Failure strength of repair devices versus meniscus suturing techniques. Knee Surg Sports Traumatol Arthrosc 10(1):25–29

    Article  PubMed  Google Scholar 

  6. Barber FA, Herbert MA (2000) Meniscal repair devices. Arthroscopy 16(7):754–756

    Article  Google Scholar 

  7. Becker R, Schroder M, Starke C, Urbach D, Nebelung W (2001) Biomechanical investigations of different meniscal repair implants in comparison with horizontal sutures on human meniscus. Arthroscopy 17(5):439–444

    Article  CAS  PubMed  Google Scholar 

  8. Becker R, Starke C, Heymann M, Nebelung W (2002) Biomechanical properties under cyclic loading of seven meniscus repair techniques. Clin Orthop 400:236–245

    Article  PubMed  Google Scholar 

  9. Becker R, Wirz D, Wolf C, Goepfert B, Nebelung W, Friederich N (2005) Measurement of meniscofemoral contact pressure after repair of bucket-handle tears with biodegradable implants. Arch Orthop Trauma Surg 125:254–260

    Article  PubMed  Google Scholar 

  10. Becker R, Brettschneider O, Gröbel KH, von Versen R, Stärke C (2006) Distraction forces on repaired bucket-handle lesions in the medial meniscus. Am J Sports Med 34(12):1941–1947

    Article  PubMed  Google Scholar 

  11. Bellemans J, Vandenneucker H, Labey L, Van Audekercke R (2002) Fixation strength of meniscal repair devices. Knee 9(1):11–14

    Article  CAS  PubMed  Google Scholar 

  12. Boenisch UW, Faber KJ, Ciarelli M, Steadman JR, Arnoczky SP (1999) Pull-out strength and stiffness of meniscal repair using absorbable arrows or Ti-Cron vertical and horizontal loop sutures. Am J Sports Med 27:626–631

    CAS  PubMed  Google Scholar 

  13. Calder S, Myers PT (1999) Broken arrow: a complication of meniscal repair. Arthroscopy 15:651–652

    Article  CAS  PubMed  Google Scholar 

  14. Charrois O (2008) Enquête de pratique SFA/ESSKA/SOFCOT. In: Symposium on Le ménisque latéral. Congrès de la Société Francaise d’Arthroscopie, Paris

    Google Scholar 

  15. Dervin GF, Downing KJ, Keene GC, McBride DG (1997) Failure strengths of suture versus biodegradable arrow for meniscal repair: an in vitro study. Arthroscopy 13:296–300

    Article  CAS  PubMed  Google Scholar 

  16. Dienst M, Seil R, Kuehne M, Kohn D (2001) Cyclic testing of meniscal sutures after in vitro culture. In: 20th Annual Meeting Arthroscopy Association of North America, Seattle, Washington

    Google Scholar 

  17. Durselen L, Schneider J, Galler M, Claes LE, Bauer G (2003) Cyclic joint loading can affect the initial stability of meniscal fixation implants. Clin Biomech (Bristol, Avon) 18:44–49

    Article  Google Scholar 

  18. Fisher SR, Markel DC, Koman JD, Atkinson TS (2002) Pull-out and shear failure strengths of arthroscopic meniscal repair systems. Knee Surg Sports Traumatol Arthrosc 10(5):294–299

    PubMed  Google Scholar 

  19. Ganko A, Engebretsen L (2000) Subcutaneous migration of meniscal arrows after failed meniscus repair. A report of two cases. Am J Sports Med 28(2):252–253

    CAS  PubMed  Google Scholar 

  20. Guisasola I, Vaquero J, Forriol F (2002) Knee immobilization on meniscal healing after suture: an experimental study in sheep. Clin Orthop 395:227–233

    Article  PubMed  Google Scholar 

  21. Kawai Y, Fukubayashi T, Nishino J (1989) Meniscal suture. An experimental study in the dog. Clin Orthop (243):286–293

    PubMed  Google Scholar 

  22. Kirsch L, Kohn D, Glowik A (1999) Forces in medial and lateral meniscus sutures during knee extension – an in vitro study. J Biomech 31(suppl.1): 104

    Google Scholar 

  23. Kocabey Y, Chang HC, Brand JC Jr, Nawab A, Nyland J, Caborn DN (2006) A biomechanical comparison of the FasT-Fix meniscal repair suture system and the RapidLoc device in cadaver meniscus. Arthroscopy 22(4):406–413

    Article  PubMed  Google Scholar 

  24. Kohn D, Siebert W (1989) Meniscus suture techniques: a comparative biomechanical cadaver study. Arthroscopy 5:324–327

    Article  CAS  PubMed  Google Scholar 

  25. Koukoubis TD, Glisson RR, Feagin J, Seaber AV, Schenkman D, Korompilias AV, Stahl DL (1997) Meniscal fixation with an absorbable staple. An experimental study in dogs. Knee Surg Sports Traumatol Arthrosc 5:22–30

    Article  CAS  PubMed  Google Scholar 

  26. McDermott ID, Richards SW, Hallam P, Tavares S, Lavelle JR, Amis AA (2003) A biomechanical study of four different meniscal repair systems, comparing pull-out strength and gapping under cyclic loading. Knee Surg Sports Traumatol Arthrosc 11:23–29

    CAS  PubMed  Google Scholar 

  27. Nyland J, Chang H, Kocabey Y, Nawab A, Brand J, Caborn DN (2008) A cyclic testing comparison of FasT-Fix and RapidLoc devices in human cadaveric meniscus. Arch Orthop Trauma Surg 128(5):489–494

    Article  CAS  PubMed  Google Scholar 

  28. Papageorgiou CD, Gil JE, Kanamori A, Fenwick JA, Woo SL, Fu FH (2001) The biomechanical interdependence between the anterior cruciate ligament replacement graft and the medial meniscus. Am J Sports Med 29:226–231

    CAS  PubMed  Google Scholar 

  29. Port J, Jackson DW, Lee TQ, Simon TM (1996) Meniscal repair supplemented with exogenous fibrin clot and autogenous cultured marrow cells in the goat model. Am J Sports Med 24:547–555

    Article  CAS  PubMed  Google Scholar 

  30. Post WR, Akers SR, Kish V (1997) Load to failure of common meniscal repair techniques: effects of suture technique and suture material. Arthroscopy 13:731–736

    Article  CAS  PubMed  Google Scholar 

  31. Rankin CC, Lintner DM, Noble PC, Paravic V, Greer E (2002) A biomechanical analysis of meniscal repair techniques. Am J Sports Med 30(4):492–497

    PubMed  Google Scholar 

  32. Richards DP, Barber FA, Herbert MA (2005) Compressive loads in longitudinal lateral meniscus tears: a biomechanical study in porcine knees. Arthroscopy 21(12):1452–1456

    Article  PubMed  Google Scholar 

  33. Rimmer MG, Nawana NS, Keene GC, Pearcy MJ (1995) Failure strengths of different meniscal suturing techniques. Arthroscopy 11:146–150

    Article  CAS  PubMed  Google Scholar 

  34. Roeddecker K, Muennich U, Nagelschmidt M (1994) Meniscal healing: a biomechanical study. J Surg Res 56:20–27

    Article  CAS  PubMed  Google Scholar 

  35. Seil R, Rupp S, Krauss PW, Benz A, Kohn D (1998) Comparison of initial fixation strength between biodegradable and metallic interference screwsand a press-fit fixation technique in a porcine model. Am J Sports Med 26(6):815–819

    CAS  PubMed  Google Scholar 

  36. Seil R, Rupp S, Dienst M, Müller B, Bonkhoff H, Kohn D (2000) Chondral lesions after arthroscopic meniscus repair using meniscus arrows. Arthroscopy 16(7): E17

    Article  Google Scholar 

  37. Seil R, Rupp S, Kohn D (2000) Cyclic testing of meniscal sutures. Arthroscopy 16:505–510

    Article  CAS  PubMed  Google Scholar 

  38. Seil R, Rupp S, Jurecka C, Rein R, Kohn D (2001) Der Einfluß verschiedener Nahtstärken auf das Verhalten von Meniskusnähten unter zyklischer Zugbelastung. Unfallchirurg 104(5):392–398

    Article  CAS  PubMed  Google Scholar 

  39. Seil R, Rupp S, Mai C, Pape D, Kohn D (2001) The footprint of meniscus fixation devices on the femoral surface of the medial meniscus: a biomechanical cadaver study. ISAKOS congress, Montreux

    Google Scholar 

  40. Seil R, Rupp S, Jurecka C, Georg T, Kohn D (2003) Réparation méniscale par fixations biodégradables: étude biomécanique comparative. Rev Chir Orthop 89:35–43

    CAS  PubMed  Google Scholar 

  41. Staerke C, Bochwitz C, Groebel K, Unterhauser F, Becker R (2004) The effect of meniscus compression on the biomechanical properties of repaired meniscal lesions. Winner of the AGA-DonJoy Award 2003. Arch Orthop Trauma Surg 124:221–225

    Article  PubMed  Google Scholar 

  42. Song EK, Lee KB (1999) Biomechanical test comparing the load to failure of the biodegradable meniscus arrow versus meniscal suture. Arthroscopy 15(7):726–732

    Article  CAS  PubMed  Google Scholar 

  43. Walsh SP, Evans SL, O’Doherty DM, Barlow IW (2001) Failure strengths of suture vs. biodegradable arrow and staple for meniscal repair: an in vitro study. Knee 8(2):129–133

    Article  Google Scholar 

  44. Whitman TL, Diduch DR (1998) Transient posterior knee pain with the meniscal arrow. Arthroscopy 14:762–763

    Article  CAS  PubMed  Google Scholar 

  45. Zantop T, Eggers AK, Musahl V, Weimann A, Hassenpflug J, Petersen W (2004) A new rigid biodegradable anchor for meniscus refixation: biomechanical evaluation. Knee Surg Sports Traumatol Arthrosc 12(4):317–324

    Article  PubMed  Google Scholar 

  46. Zantop T, Eggers AK, Weimann A, Hassenpflug J, Petersen W (2004) Initial fixation strength of flexible all-inside meniscus suture anchors in comparison to conventional suture technique and rigid anchors: biomechanical evaluation of new meniscus refixation systems. Am J Sports Med 32(4):863–869

    Article  PubMed  Google Scholar 

  47. Zantop T, Eggers AK, Mushal V, Weimann A, Petersen W (2005) Cyclic testing of flexible all-inside meniscus suture anchors: biomechanical analysis. Am J Sports Med 33:388–394

    Article  PubMed  Google Scholar 

  48. Zantop T, Temmig K, Weimann A, Eggers AK, Raschke MJ, Petersen W (2006) Elongation and structural properties of meniscal repair using suture techniques in distraction and shear force scenarios: biomechanical evaluation using a cyclic loading protocol. Am J Sports Med 34(5):799–805

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. Seil .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Seil, R., Pape, D. (2010). Meniscal Repair: Biomechanics. In: Beaufils, P., Verdonk, R. (eds) The Meniscus. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02450-4_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-02450-4_15

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-02449-8

  • Online ISBN: 978-3-642-02450-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics