Incidence and Mode of Deployment Failure of the Fast-Fix 360™ Meniscal Repair Device

Abstract

Background Meniscal repair device deployment failure is a recognised complication of all-inside meniscal repair with subsequent risk of patient harm. The Fast-Fix device has undergone design changes to reduce deployment failure since its introduction in 2001. Purpose The purpose of this study was to assess the incidence and mechanism of intra-operative deployment failure of the 3 rd generation Fast-fix 360™ (Smith & Nephew, Andover, USA) device. Method Data was prospectively collected for 106 consecutive all-inside meniscal repairs undertaken with the Fast-fix 360™ device. Patient demographics, mechanism of failure, site and type of repair were recorded. Results 20 deployment failures occurred in 423 Fast-fix 360™ deployments, an incidence of 4.72%. Deployment failure occurred in 19 of 109 patients an incidence of 17.43%. Six different failure mechanisms occurred; anchor exiting device without trigger being initiated, anchors not holding in meniscus, both anchors simultaneously exiting device and braided suture failing. The most common failure mechanism was failure of the second anchor not holding in the meniscus. Average cost of device failure was $75 per patient. Conclusion Despite design modification, deployment failure still occurs with similar modes top to the original design.