Objectives: To evaluate the load to failure and meniscus gapping of longitudinal meniscus repairs with Soft Suture Based all-inside devices and compare them to a polyether ether ketone (PEEK) anchored device and inside-out repair. Methods: After IRB review 12 human cadaver knees were dissected leaving only the tibia, the posterior capsule and the medial and lateral menisci with roots still attached to the tibia. This yielded 24 menisci total (12 medial, 12 lateral). Posterior horn longitudinal full thickness meniscus tears were simulated with a scapel and 5mm Mersiline tapes were used to load the repair site. Each knee was randomized to one of 4 meniscus repair groups: Fiberstitch, Juggerstitch, FAST-FIX 360(PEEK), and inside-out with Broadband tape meniscus needles. For each meniscus, 2 longitudinal repairs were performed. The specimens were tested with an Instron imposing 20 cycles between 10N and 30N then the tear gap was measured, followed by a distraction to failure phase after imposing a displacement at a rate of 0.5mm/sec. Results: There There were 6 menisci tested in each of the 4 groups. After low-load cyclical loading, the gaps measured were .63mm, 1.1mm, 1.7mm, and 1.2mm for the Juggerstitch, Fiberstitch, FAST-FIX 360, and Inside-out Groups respectively (see figure 2). The failure load was 352N, 301N, 167N, and 189N for the Juggerstitch, Fiberstitch, FAST-FIX 360, and Inside-out (see figure 3). There was less gap formation and higher load to failure for the Juggerstitch over the FAST-FIX 360 (p=.014 and p=.03, respectively). When comparing all other groups there was no significant difference between groups with respect to gapping or failure load. Conclusions: The Juggerstitch had less gapping at the repair site and a higher failure load than the FAST-FIX 360. The soft suture based All-Inside meniscus repair devices have gapping and failure load comparable or better than traditional repair devices.

This article describes a technique for arthroscopic fixation of an osteochondritis dissecans (OCD) lesion of the medial talar dome with headless compression screws. This technique involves creation of a medial transmalleolar portal using a guide and drill. The medial transmalleolar portal grants perpendicular access for screw fixation of OCD lesions in addition to the potential for osteochondral autograft transplantation (OAT). Advantages include access to the medial talar dome without performing a medial malleolar osteotomy. After completion of OCD fixation, an inverted osteochondral plug can be used to backfill the portal.