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The all-inside all-suture technique demonstrated better biomechanical behaviors in meniscus radial tear repair

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to evaluate the effectiveness of three constructs and techniques for repair of radial tears of the meniscus.

Methods

Thirty fresh frozen porcine menisci were divided equally into three groups consisting of (1) inside-out repair group, (2) a commonly used all-inside suture with anchor hybrid repair construct (AISAH) (Meniscal Cinch™), and (3) an all-inside all-suture repair construct (AIAS) (Knee Scorpion™). Radial tears were created and repaired and then the menisci were secured to the materials testing machine. Both cyclic loading and load-to-failure testing were performed. The displacement, stiffness, response to cyclic loading, and mode of failure were recorded and analyzed statistically.

Results

The displacement after cyclic loading (DACL) of the Cinch repair construct group was significantly higher than that of the inside-out repair construct group (p = 0.000) and AIAS repair construct (p = 0.000). There was not a statistical difference of DACL between inside-out and AIAS groups (n.s.). The inside-out construct failed at a significantly higher load than the AISAH repair construct (p = 0.000) and AIAS construct (p = 0.006). The AIAS construct failed at a significantly higher load than the AISAH repair construct (p = 0.009). The AIAS had a higher stiffness than AISAH (p = 0.047). The AIAS had a higher load at 3 mm protrusion than AISAH (p = 0.034).

Conclusion

The AIAS repair construct had better biomechanical behaviors than AISAH construct and inside-out repair technique. Inside-out sutures and AIAS repair construct had similar biomechanical responses to cyclic loading. The AIAS can be used for meniscus tear surgical repair with less damage to peri-meniscus tissues.

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Acknowledgements

The authors acknowledge Lin Gross, Rachel Toccalino, and E.J. Rozek of the Detroit Medical Center for their assistance in all aspects of this study.

Funding

No funding was used to support this study.

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Authors and Affiliations

  1. Detroit Medical Center Sports Medicine, DMC Sports Medicine Orthopaedic Surgery Fellowship Program, 3990 John R Street, PO Box 137, Detroit, MI, 48201, USA

    Timothy Doig, Todd Frush, Lisa Lovse & Stephen Lemos

  2. Department of Orthopaedic Surgery and Sports Medicine, Detroit Medical Center, 3990 John R Street, PO Box 137, Detroit, MI, 48201, USA

    Paul Fagan, Todd Frush, Chaoyang Chen & Stephen Lemos

Authors
  1. Timothy Doig
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  2. Paul Fagan
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  3. Todd Frush
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  4. Lisa Lovse
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  6. Stephen Lemos
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Corresponding authors

Correspondence to Chaoyang Chen or Stephen Lemos.

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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethics statement

The menisci used in this study were obtained from fresh swine carcasses and IRB approval was not required for this study. We did not kill or euthanize swine to harvest swine menisci.

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Informed consent was not necessary for this study.

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Doig, T., Fagan, P., Frush, T. et al. The all-inside all-suture technique demonstrated better biomechanical behaviors in meniscus radial tear repair. Knee Surg Sports Traumatol Arthrosc 28, 3606–3612 (2020). https://doi.org/10.1007/s00167-020-06078-2

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