P098 Forces in medial and lateral meniscus sutures during knee extension-an in vitro study

Initial Fixation Strength of Flexible All-Inside Meniscus Suture Anchors in Comparison to Conventional Suture Technique and Rigid Anchors

“…Since the tissue is functionally adapted to its strain, 31 it seems likely that under in vivo conditions only low forces occur in the radial direction. Kirsch et al 25 investigated the forces occurring in meniscus sutures in a cadaveric model and found low forces that were never higher than 10 N. Koukoubis et al 27 showed in a canine model that the repair tissue after meniscus suture failed at 46 N. In addition, as in this study, most biomechanical research studies test a worst-case scenario, in which the load is applied parallel to the axis of the tested fixation device. Although the exact forces to which a meniscus repair is subjected in vivo are unknown, this setup may not reflect the in vivo situation.…”

“…Unfortunately, it is not known exactly how much fixation strength is needed to ensure a satisfactory repair, and the necessary fixation strength for meniscal healing is still in question. 25 Proctor et al 36 determined the material properties of the bovine meniscus and found a mean Young's modulus of 2.8 MPa for radially oriented samples and of 198.4 MPa for circumferentially oriented samples. Since the tissue is functionally adapted to its strain, 31 it seems likely that under in vivo conditions only low forces occur in the radial direction.…”

Cyclic Testing of 3 All-Inside Meniscal Repair Devices

“…37,38 Previous studies of vertical mattress sutures used for meniscal repair (inside-out techniques) have demonstrated load to failure rates between 70 and 202 N. 2,6,11,21,29 It is difficult to translate these numbers into clinical relevancy because the strength that a meniscal repair device needs to be to allow for meniscal healing is unknown. Previous in vitro studies have shown that the meniscal repair site experiences loads of only up to 10 N. 19 It is also clear that the forces seen by the meniscus are not simply distractive forces and contain a larger component of shear and compressive forces. 30,31 Despite this fact, it is generally believed that the stronger the meniscal repair the better, although there likely is a threshold over which a stronger repair does not have much effect on meniscal healing.…”

Arthroskopische Meniskusrefixierung mit bioresorbierbaren Implantaten

“…Kirsch et al [26] simulated dynamic extension on a knee kinemator on five human cadaver knees. During extension, a sensor measured the strength of a 3 cm long longitudinal posterior horn meniscal tear repaired with T-Fix anchors.…”