Meniscal Repair with Biofix Arrows

Abstract

Meniscal repair with Biofix arrows has an unacceptably low rate of success.

Long-term outcome after meniscal repair

“…The most important finding of this study was the identification of some prognostic factors that correlate with a higher success rate in meniscal repair. Most long‐term follow‐up studies on meniscal repair seem to achieve a clinical success rate between 59 and 100% [5, 14, 18, 19, 22, 27, 28, 34, 35, 38, 41]. This is comparable to the 74% success rate found in the current study at an average follow‐up of 70 months.…”

“…Although some authors have found good short‐ and mid‐term results with bioabsorbable arrows [5, 22], other recent studies with long‐term follow‐up have found unsatisfactory outcomes and unacceptably low success ratio [14, 25, 26, 30, 35]. From a biomechanical standpoint, vertical sutures provide superior initial fixation strengths when compared with horizontal sutures, which in turn are equivalent or superior to most of the available absorbable all‐inside devices [13, 16, 17, 24, 30].…”

All-inside suture device is superior to meniscal arrows in meniscal repair: a prospective randomized multicenter clinical trial with 2-year follow-up

“…The main finding of this prospective randomized study was a 3.6 times higher risk of reoperation within 2 years following meniscal repair with Biofix ® meniscal arrows compared to repair with FasT-Fix ® meniscal suture. The reoperation rates are consistent with earlier studies [ 7 , 10 , 13 ] and give support to today’s clinical practice where biodegradable arrows are used less frequent.…”

“…With a 20 % suggested dropout rate at 2 years, the plan was to include 120 patients (60 in each group). However, we chose to interpret our own data at the inclusion of 46 patients, since new information from other studies revealed favourable results using suture techniques compared to meniscal arrows [ 7 , 10 ]. Based on the results of our own preliminary data, we found it unethical to continue the recruitment of patients.…”

Long-term outcome after all-inside meniscal repair using the RapidLoc system

“…While it is possible that the poor long‐term outcome of the present study is due to some inherent hapless property of the RapidLoc implant, it is equally possible that a similar failure rate will be found in other implants used for isolated all‐inside repairs, if followed up for a similar period of time. In support for such a view—the negative effect of increasing follow‐up time—is the fact that whereas Albrecht‐Olsen et al [1] found 18 % non‐healed or only partly healed menisci at re‐arthroscopy 3–4 months after the repair with resorbable meniscus arrows, the failure rate (using the same implant) in the medium‐ and long term has been reported to be 30 % at the 2‐year follow‐up [19] and 41 % at a mean 4.7‐year follow‐up [11]. In opposition to the findings in meniscus arrows (and the present study), Pujol et al [27], using Fast‐Fix implants with or without supplementary mattress sutures, did not find deterioration in outcome with time.…”