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Tensile strength of the pullout repair technique for the medial meniscus posterior root tear: a porcine study

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Abstract

Purpose

The purpose of this study was to compare the load-to-failure of different common suturing techniques with a new technique for the medial meniscus posterior root tear (MMPRT).

Methods

Thirty porcine medial menisci were randomly assigned to three suturing techniques used for transtibial pullout repair of the MMPRT (n = 10 per group). Three different meniscal suture configurations were studied: the two simple suture (TSS) technique, the conventional modified Mason-Allen suture (MMA) technique, and the new MMA technique using the FasT-Fix combined with the Ultrabraid (F-MMA). The ultimate failure load was tested using a tensile testing machine.

Results

The MMA and F-MMA groups demonstrated significantly higher failure loads than the TSS group (P = 0.0003 and P = 0.0005, respectively). No significant differences were observed between the MMA and F-MMA groups (P = 0.734).

Conclusions

The ultimate failure load was significantly greater in the F-MMA than the TSS group and similar to the conventional MMA technique.

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References

  1. Bhatia S, LaPrade CM, Ellman MB, LaPrade RF (2014) Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med 42(12):3016–3030

    Article  PubMed  Google Scholar 

  2. Fithian DC, Kelly MA, Mow VC (1990) Material properties and structure-function relationships in the menisci. Clin Orthop Relat Res 252:19–31

    Google Scholar 

  3. Andrews SH, Rattner JB, Jamniczky HA, Shrive NG, Adesida AB (2015) The structural and compositional transition of the meniscal roots into the fibrocartilage of the menisci. J Anat 226(2):169–174

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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

    Article  PubMed  Google Scholar 

  5. Ahn JH, Wang JH, Lim HC, Bae JH, Park JS, Yoo JC, Shyam AK (2009) Double transosseous pull out suture technique for transection of posterior horn of medial meniscus. Arch Orthop Trauma Surg 129(3):387–392

    Article  PubMed  Google Scholar 

  6. Kim YM, Rhee KJ, Lee JK, Hwang DS, Yang JY, Kim SJ (2006) Arthroscopic pullout repair of a complete radial tear of the tibial attachment site of the medial meniscus posterior horn. Arthroscopy 22(7):795.e1–795.e4

    Google Scholar 

  7. Lavender CD, Hanzlik SR, Caldwell PE 3rd, Pearson SE (2015) Transosseous medial meniscal root repair using a modified Mason-Allen suture configuration. Arthrosc Tech 4(6):e781–e784

    Article  PubMed  PubMed Central  Google Scholar 

  8. Apivatgaroon A, Chernchujit B (2016) A medial meniscal root pullout repair with the use of a tibial tunnel suturing technique. Arthrosc Tech 5(3):e595–e599

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chung KS, Ha JK, Ra HJ, Kim JG (2016) Arthroscopic medial meniscus posterior root fixation using a modified Mason-Allen stitch. Arthrosc Tech 5(1):e63–e66

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kodama Y, Furumatsu T, Fujii M, Tanaka T, Miyazawa S, Ozaki T (2016) Pullout repair of a medial meniscus posterior root tear using a FasT-fix all-inside suture technique. Orthop Traumatol Surg Res 102(7):951–954

    Article  CAS  PubMed  Google Scholar 

  11. Furumatsu T, Kodama Y, Fujii M, Tanaka T, Hino T, Kamatsuki Y, Yamada K, Miyazawa S, Ozaki T (2017) A new aiming guide can create the tibial tunnel at favorable position in transtibial pullout repair for the medial meniscus posterior root tear. Orthop Traumatol Surg Res 103(3):367–371

  12. Moon HK, Koh YG, Kim YC, Park YS, Jo SB, Kwon SK (2012) Prognostic factors of arthroscopic pullout repair for a posterior root tear of the medial meniscus. Am J Sports Med 40(5):1138–1143

    Article  PubMed  Google Scholar 

  13. Park YS, Moon HK, Koh YG, Kim YC, Sim DS, Jo SB, Kwon SK (2011) Arthroscopic pullout repair of posterior root tear of the medial meniscus: the anterior approach using medial collateral ligament pie-crusting release. Knee Surg Sports Traumatol Arthrosc 19(8):1334–1336

    Article  PubMed  Google Scholar 

  14. Feucht MJ, Grande E, Brunhuber J, Burgkart R, Imhoff AB, Braun S (2013) Biomechanical evaluation of different suture techniques for arthroscopic transtibial pullout repair of posterior medial meniscus root tears. Am J Sports Med 41(12):2784–2790

    Article  PubMed  Google Scholar 

  15. Fujii M, Furumatsu T, Kodama Y, Miyazawa S, Hino T, Kamatsuki Y, Yamada K, Ozaki T (2017) A novel suture technique using the FasT-Fix combined with Ultrabraid for pullout repair of the medial meniscus posterior root tear. Eur J Orthop Surg Traumatol 27(4):559–562

  16. LaPrade RF, LaPrade CM, Ellman MB, Turnbull TL, Cerminara AJ, Wijdicks CA (2015) Cyclic displacement after meniscal root repair fixation: a human biomechanical evaluation. Am J Sports Med 43(4):892–898

    Article  PubMed  Google Scholar 

  17. Feucht MJ, Grande E, Brunhuber J, Rosenstiel N, Burgkart R, Imhoff AB, Braun S (2015) Biomechanical evaluation of different suture materials for arthroscopic transtibial pullout repair of posterior meniscus root tears. Knee Surg Sports Traumatol Arthrosc 23(1):132–139

    Article  PubMed  Google Scholar 

  18. Anz AW, Branch EA, Saliman JD (2014) Biomechanical comparison of arthroscopic repair constructs for meniscal root tears. Am J Sports Med 42(11):2699–2706

    Article  PubMed  Google Scholar 

  19. Feucht MJ, Grande E, Brunhuber J, Rosenstiel N, Burgkart R, Imhoff AB, Braun S (2014) Biomechanical comparison between suture anchor and transtibial pullout repair for posterior medial meniscus root tears. Am J Sports Med 42(1):187–193

    Article  PubMed  Google Scholar 

  20. Stärke C, Kopf S, Lippisch R, Lohmann CH, Becker R (2013) Tensile forces on repaired medial meniscal root tears. Arthroscopy 29(2):205–212

    Article  PubMed  Google Scholar 

  21. Marzo JM, Gurske-DePerio J (2009) Effects of medial meniscus posterior horn avulsion and repair on tibiofemoral contact area and peak contact pressure with clinical implications. Am J Sports Med 37:124–129

    Article  PubMed  Google Scholar 

  22. Seo JH, Li G, Shetty GM, Kim JH, Bae JH, Jo ML, Kim JS, Lee SJ, Nha KW (2009) Effect of repair of radial tears at the root of the posterior horn of the medial meniscus with the pullout suture technique: a biomechanical study using porcine knees. Arthroscopy 25(11):1281–1287

    Article  PubMed  Google Scholar 

  23. Krych AJ, Reardon PJ, Johnson NR, Mohan R, Peter L, Levy BA, Stuart MJ (2017) Non-operative management of medial meniscus posterior horn root tears is associated with worsening arthritis and poor clinical outcome at 5-year follow-up. Knee Surg Sports Traumatol Arthrosc 25(2):383–389

    Article  PubMed  Google Scholar 

  24. Kim SB, Ha JK, Lee SW, Kim DW, Shim JC, Kim JG, Lee MY (2011) Medial meniscus root tear refixation: comparison of clinical, radiologic, and arthroscopic findings with medial meniscectomy. Arthroscopy 27(3):346–354

    Article  PubMed  Google Scholar 

  25. Kopf S, Colvin AC, Muriuki M, Zhang X, Harner CD (2011) Meniscal root suturing techniques: implications for root fixation. Am J Sports Med 39(10):2141–2146

    Article  PubMed  Google Scholar 

  26. Aros BC, Pedroza A, Vasileff WK, Litsky AS, Flanigan DC (2010) Mechanical comparison of meniscal repair devices with mattress suture devices in vitro. Knee Surg Sports Traumatol Arthrosc 18(11):1594–1598

    Article  PubMed  Google Scholar 

  27. Barber FA, Herbert MA, Richards DP (2004) Load to failure testing of new meniscal repair devices. Arthroscopy 20(1):45–50

    Article  PubMed  Google Scholar 

  28. Borden P, Nyland J, Caborn DN, Pienkowski D (2013) Biomechanical comparison of the FasT-fix meniscal repair suture system with vertical mattress sutures and meniscus arrows. Am J Sports Med 31(3):374–378

    Article  Google Scholar 

  29. Chang HC, Nyland J, Caborn DN, Burden R (2013) Biomechanical evaluation of meniscal repair systems: a comparison of the meniscal viper repair system, the vertical mattress FasT-fix device, and vertical mattress ethibond sutures. Am J Sports Med 33(12):1846–1852

    Article  Google Scholar 

  30. 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 

  31. Röpke EF, Kopf S, Drange S, Becker R, Lohmann CH, Stärke C (2015) Biomechanical evaluation of meniscal root repair: a porcine study. Knee Surg Sports Traumatol Arthrosc 23(1):45–50

    Article  PubMed  Google Scholar 

  32. Kim YM, Joo YB, Noh CK, Park IY (2016) The optimal suture site for the repair of posterior horn root tears: biomechanical evaluation of pullout strength in porcine menisci. Knee Surg Relat Res 28(2):147–152

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Takayuki Furumatsu.

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Fujii, M., Furumatsu, T., Xue, H. et al. Tensile strength of the pullout repair technique for the medial meniscus posterior root tear: a porcine study. International Orthopaedics (SICOT) 41, 2113–2118 (2017). https://doi.org/10.1007/s00264-017-3561-8

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  • DOI: https://doi.org/10.1007/s00264-017-3561-8

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