gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2012)

23.10. - 26.10.2012, Berlin

Comparison of All-Inside Meniscal Repair Devices with Matched Inside-Out Suture Repair

Vergleich von all-Inside Meniskus-Refixationen mit ihren übereinstimmenden inside-out Techniken

Meeting Abstract

  • presenting/speaker Claudio Rosso - Universitätsspital Basel, Universität Basel, Orthopädische Klinik, Basel, Switzerland
  • Konstantin Kovtun - Harvard Medical School, Boston, United States
  • Brett McKenzie - Beth Israel Deaconess Medical Center, Harvard Medical School, Center for Advanced Orthopaedic Studies, Boston, United States
  • Ara Nazarian - Beth Israel Deaconess Medical Center, Harvard Medical School, Center for Advanced Orthopaedic Studies, Boston, United States
  • Victor Valderrabano - Universitätsspital Basel, Universität Basel, Orthopädische Klinik, Basel, Switzerland
  • Joseph P. DeAngelis - Beth Israel Deaconess Medical Center, Harvard Medical School, Department of Orthopaedic Surgery, Boston, United States
  • Arun J. Ramappa - Beth Israel Deaconess Medical Center, Harvard Medical School, Department of Orthopaedic Surgery, Boston, United States

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2012). Berlin, 23.-26.10.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocPO16-960

doi: 10.3205/12dkou593, urn:nbn:de:0183-12dkou5937

Veröffentlicht: 2. Oktober 2012

© 2012 Rosso et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Fragestellung: All-inside meniscus repairs are performed with increasing frequency due to the availability of newly developed devices. A comparison of their biomechanical characteristics may aid physicians in selecting a method of meniscal repair.

All-inside meniscal repairs are the upcoming standard. We tested initial displacement, cyclic loading and load-to-failure of the Ultra FasT-Fix, the Meniscal Cinch and their inside-out controls.

Methodik: In this controlled laboratory study, sixty-six bucket-handle tears in matched porcine menisci were repaired using the Ultra FasT-Fix, Meniscal Cinch, Ultrabraid No. 0 and FiberWire 2-0 sutures. Initial displacement, cyclic loading (100, 300 and 500 cycles) and load-to-failure testing were performed. The displacement, response to cyclic loading, and mode of failure were recorded. The stiffness was calculated.

Ergebnisse und Schlussfolgerungen: The Meniscal Cinch demonstrated a significantly higher initial displacement than the other methods tested (p=0.04). No significant difference was found among the methods in response to cyclic loading. The inside-out FiberWire repair demonstrated the highest load-to-failure (120.8±23.5 N) and was significantly higher than both the Meniscal Cinch (64.8±24.1 N, p<0.001) and the Ultra FasT-Fix (88.3±14.3 N, p=0.002). It was not significantly higher than the inside-out Ultrabraid suture repair (98.8±29.2N). The inside-out FiberWire repair had the highest stiffness (28.7±7.8 N/mm). It was significantly higher than the Meniscal Cinch (18.0±8.8 N/mm, p =0.01). The most common mode of failure in all methods was suture failure.

An inside-out suture repair affords surgeons the best overall biomechanical characteristics of the devices tested (initial displacement, response to cyclic loading, and load to failure). For an all-inside repair, the Ultra FasT-Fix reproduces the characteristics of its matched inside-out suture repair more closely than the Meniscal Cinch. Initial displacement demonstrates the degree of contact at the level of the repaired tear. This is difficult to evaluate arthroscopically and hence needs to be evaluated in biomechanical testing.