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

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.