The Optimal Suture Site for the Repair of Posterior Horn Root Tears: Biomechanical Evaluation of Pullout Strength in Porcine Menisci

Overview

Journal Knee Surg Relat Res

Publisher Biomed Central

Date 2016 Jun 9

PMID 27274472

Citations 8

Authors

Young-Mo Kim

Yong-Bum Joo

Chang-Kyun Noh

Il-Young Park

Affiliations

Soon will be listed here.

Abstract

Purpose: There are few studies on biomechanical evaluation of suture points in repair of root tears. The purpose of this study was to determine the point of greatest pullout strength for root tear repair.

Materials And Methods: A total of 120 fresh porcine medial menisci were obtained. The red-red and red-white zones of the meniscus were divided by two lines designated as lines A and B (groups A and B). Groups A and B were further divided into three groups each by dividing lines A and B into three points: 3, 5, and 7 mm from the meniscal ligament root insertion. Vertical meniscal repair was performed on each point. The pullout failure strength was tested using a biaxial servohydraulic testing machine.

Results: The average maximal load at failure was significantly greater in group A than group B (87.65 vs. 62.93; p<0.001) The average length at maximal load failure was greater in group A than group B (4.35 vs. 3.2; p<0.001). Among the subgroups of 3, 5, and 7 mm in both groups A and B, 7 mm showed the greatest maximal load (p<0.001).

Conclusions: The pullout strength was statistically significantly greater in group A than group B and in the 7 mm subgroup than the 3 and 5 mm subgroups. Thus, the 7 mm subgroup in group A showed the greatest pullout strength.

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References

Lee J, Lim Y, Kim K, Kim K, Song J . Arthroscopic pullout suture repair of posterior root tear of the medial meniscus: radiographic and clinical results with a 2-year follow-up. Arthroscopy. 2009; 25(9):951-8. DOI: 10.1016/j.arthro.2009.03.018. View

Allaire R, Muriuki M, Gilbertson L, Harner C . Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am. 2008; 90(9):1922-31. DOI: 10.2106/JBJS.G.00748. View

Ahmed A, Burke D . In-vitro measurement of static pressure distribution in synovial joints--Part I: Tibial surface of the knee. J Biomech Eng. 1983; 105(3):216-25. DOI: 10.1115/1.3138409. View

Nicholas S, Golant A, Schachter A, Lee S . A new surgical technique for arthroscopic repair of the meniscus root tear. Knee Surg Sports Traumatol Arthrosc. 2009; 17(12):1433-6. DOI: 10.1007/s00167-009-0874-1. View

Feucht M, Grande E, Brunhuber J, Rosenstiel N, Burgkart R, Imhoff A . Biomechanical comparison between suture anchor and transtibial pull-out repair for posterior medial meniscus root tears. Am J Sports Med. 2013; 42(1):187-93. DOI: 10.1177/0363546513502946. View

LaPrade C, LaPrade M, Turnbull T, Wijdicks C, LaPrade R . Biomechanical evaluation of the transtibial pull-out technique for posterior medial meniscal root repairs using 1 and 2 transtibial bone tunnels. Am J Sports Med. 2015; 43(4):899-904. DOI: 10.1177/0363546514563278. View

Bolano L, Grana W . Isolated arthroscopic partial meniscectomy. Functional radiographic evaluation at five years. Am J Sports Med. 1993; 21(3):432-7. DOI: 10.1177/036354659302100318. View

Englund M . Meniscal tear--a feature of osteoarthritis. Acta Orthop Scand Suppl. 2004; 75(312):1-45, backcover. View

Choi N, Son K, Victoroff B . Arthroscopic all-inside repair for a tear of posterior root of the medial meniscus: a technical note. Knee Surg Sports Traumatol Arthrosc. 2008; 16(9):891-3. DOI: 10.1007/s00167-008-0581-3. View

10.

Kohn D, Siebert W . Meniscus suture techniques: a comparative biomechanical cadaver study. Arthroscopy. 1989; 5(4):324-7. DOI: 10.1016/0749-8063(89)90150-3. View

11.

Costa C, Morrison W, Carrino J . Medial meniscus extrusion on knee MRI: is extent associated with severity of degeneration or type of tear?. AJR Am J Roentgenol. 2004; 183(1):17-23. DOI: 10.2214/ajr.183.1.1830017. View

12.

LaPrade R, LaPrade C, Ellman M, Turnbull T, Cerminara A, Wijdicks C . Cyclic displacement after meniscal root repair fixation: a human biomechanical evaluation. Am J Sports Med. 2015; 43(4):892-8. DOI: 10.1177/0363546514562554. View

13.

Jorgensen U, Sonne-Holm S, Lauridsen F, ROSENKLINT A . Long-term follow-up of meniscectomy in athletes. A prospective longitudinal study. J Bone Joint Surg Br. 1987; 69(1):80-3. DOI: 10.1302/0301-620X.69B1.3818740. View

14.

Feucht M, Grande E, Brunhuber J, Rosenstiel N, Burgkart R, Imhoff A . Biomechanical evaluation of different suture materials for arthroscopic transtibial pull-out repair of posterior meniscus root tears. Knee Surg Sports Traumatol Arthrosc. 2013; 23(1):132-9. DOI: 10.1007/s00167-013-2656-z. View

15.

Kim Y, Joo Y . Pullout failure strength of the posterior horn of the medial meniscus with root ligament tear. Knee Surg Sports Traumatol Arthrosc. 2012; 21(7):1546-52. DOI: 10.1007/s00167-012-2131-2. View

16.

Fukuda Y, Takai S, Yoshino N, Murase K, Tsutsumi S, Ikeuchi K . Impact load transmission of the knee joint-influence of leg alignment and the role of meniscus and articular cartilage. Clin Biomech (Bristol). 2000; 15(7):516-21. DOI: 10.1016/s0268-0033(00)00013-9. View

17.

Ahn J, Wang J, Yoo J, Noh H, Park J . A pull out suture for transection of the posterior horn of the medial meniscus: using a posterior trans-septal portal. Knee Surg Sports Traumatol Arthrosc. 2007; 15(12):1510-3. DOI: 10.1007/s00167-007-0310-3. View

18.

Nishimura A, Hasegawa M, Kato K, Yamada T, Uchida A, Sudo A . Risk factors for the incidence and progression of radiographic osteoarthritis of the knee among Japanese. Int Orthop. 2010; 35(6):839-43. PMC: 3103966. DOI: 10.1007/s00264-010-1073-x. View

19.

McGinity J, Geuss L, Marvin R . Partial or total meniscectomy: a comparative analysis. J Bone Joint Surg Am. 1977; 59(6):763-6. View

20.

McDermott I, Amis A . The consequences of meniscectomy. J Bone Joint Surg Br. 2006; 88(12):1549-56. DOI: 10.1302/0301-620X.88B12.18140. View