Biomechanical Study of Meniscal Repair Using Horizontal Sutures and Vertical Loop Techniques

Abstract

Background:Meniscus plays an important role in weight-bearing and energy absorption. Moreover, its function is optimal to maintain joint stability and congruous. Treatments for meniscus damage or meniscus tear include open or arthroscopic repair and meniscectomy. One of the most important factors that influence patients’ recovery outcome is restoration technique. The purpose of this study was to compare the strength of recently new method of meniscus repair, submeniscal horizontal sutures, and single vertical loop suturing techniques in meniscus repair.Materials and Methods:An experimental study was conducted to study 12 ruptured medial meniscuses of bulls, which were divided into two groups of six meniscuses equally. In this study, submeniscal horizontal and vertical loop suturing techniques were compared based on their resistance to tensile forces and the stability of repaired gaps.Results:In this study, submeniscal horizontal and vertical loop knots were 104.3 ± 12.5 N and 110.7 ± 16.4 N, respectively. No significant difference was found between the two groups. To measure the stability of the gap, 95.4 ± 8.7 N tensile force was applied to submeniscal and 124.6 ± 11.7 N to vertical loop techniques. There was significantly different in gap stability between horizontal and vertical loop techniques in meniscal repair (P = 0.02).Conclusion:The results of this study indicate that knot resistance in submeniscal horizontal is similar to vertical loop resistance. The stability of the restored gap in vertical loop technique is more than submeniscal horizontal techniques. Vertical loop causes greater stability against tensile force.

The Role of the Pie-Crusting Technique of the Medial Collateral Ligament in the Arthroscopic Inside-out Technique for Medial Meniscal Repair With or Without Anterior Cruciate Ligament Reconstruction: A Satisfactory Repair Technique

“… 18 , 19 In our study, no correlation was found between the Lysholm score and patients having undergone ACL repair (or not). In our experience, vertical stitches were more stable than horizontal stitches for meniscal repair, which was also shown in a biomechanical study by Tabrizi and Shariyate, 20 stating that a vertical loop caused greater stability against tensile force.…”

Radial and longitudinal meniscus tears show different gapping patterns under stance phase conditions

“…Therefore, to advance the development of repair strategies and related rehabilitation regimes, a detailed analysis of meniscal tears and their biomechanical behaviour is of great interest. The first approaches to quantify meniscal tear gapping were simplified uniaxial ex vivo tensile tests using standard testing machines 20–28 . Other groups have utilized magnetic resonance imaging (MRI) 29–32 to assess meniscal gapping in vivo under static knee flexion angles.…”

“…The first approaches to quantify meniscal tear gapping were simplified uniaxial ex vivo tensile tests using standard testing machines. [20][21][22][23][24][25][26][27][28] Other groups have utilized magnetic resonance imaging (MRI) [29][30][31][32] to assess meniscal gapping in vivo under static knee flexion angles. Dürselen et al were one of the first to identify gapping under moderate dynamic loading conditions by means of a knee simulator 33,34 and found a significant gapping behaviour of longitudinal tears.…”

“…By contrast, McCulloch and Lin et al in their studies rather observed a compression of longitudinal tears under gait-like conditions, 35,36 leading to significant debate. From a technological point of view, meniscus gapping was assessed optically by movement deflection, [20][21][22][23][24][25][26][27][28] MRI, [29][30][31][32] arthroscopically 33,34 and Roentgen stereophotogrammetric analysis (RSA). 35,36 To the best of the authors' knowledge, meniscal tear gapping has only been studied independently of the related tibiofemoral contact pressure, which is an important contributor to a healthy knee joint.…”