gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2014)

28.10. - 31.10.2014, Berlin

Meta-Analysis on Biomechanical Properties of Meniscus Repairs. Are Devices better than Sutures?

Meeting Abstract

  • presenting/speaker Matthias Wimmer - Department of Orthopaedic Surgery, University Hospital Bonn, University of Bonn, Bonn, Germany
  • Dan Buckland - University Hospital Basel, University of Basel, Orthopaedic Department, Basel, Switzerland
  • Patrick Sadoghi - Department of Orthopaedic Surgery, Medical University Graz, Graz, Austria
  • Patrick Vavken - Department of Orthopedic Surgery, Children´s Hospital Boston, Harvard Medical School, Boston, United States
  • Victor Valderrabano - University Hospital Basel, University of Basel, Orthopaedic Department, Basel, Switzerland
  • Claudio Rosso - University Hospital Basel, University of Basel, Orthopaedic Department, Basel, Switzerland

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2014). Berlin, 28.-31.10.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocPO23-1318

doi: 10.3205/14dkou751, urn:nbn:de:0183-14dkou7510

Published: October 13, 2014

© 2014 Wimmer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Meniscal repair devices have been extensively tested during the past decades as reported in the literature. Reviewing the different meniscal repair devices and sutures with their respective biomechanical properties.

Method: For this meta-analysis, we conducted a systematic online search using PubMed, EMBASE, CCTR, and CINAHL using the search terms “Meniscus OR Meniscal AND Biomechanics AND Repair”. Load-to-failure (LtF), stiffness, and cyclic outcome measures were extracted independently and in duplicate. The systematic search revealed 841 manuscripts in total. After exclusion of duplicates and irrelevant publications, 41 studies remained for final analysis. The studies were published in English and German from 1995 to 2013. Due to differing cyclic force protocols, cyclic outcomes had to be excluded.

Results: Overall, sutures had a higher load-to-failure (suture: 87.7±0.3 N (weighted mean±standard error), device: 56.3±0.1 N) and stiffness (suture: 8.9±0.1 N/mm, device: 8.6±0.04 N/mm) than devices, both p<0.05. In LfT testing, PDS 0 Vertical (145.0±8.1 N), OrthoCord 2-0 (143.6±11.3 N) and Ethibond No 0 Vertical (133.4±7.7 N) were the strongest sutures and Meniscal Viper (140.9±5.1 N), MaxFire Vertical (136.2±11.3 N) and FasT-Fix Vertical (115.2±1.6 N) were the strongest devices. Second-generation devices were significantly stronger and stiffer than first-generation devices (p<0.001).

Clinical Relevance: Suture repair remains the gold standard with a vertically oriented suture configuration showing superior load-to-failure values compared to a horizontal configuration. Nevertheless, some meniscal repair devices have similar biomechanical properties to suture repairs. Both suture repairs and devices have a place in meniscal restoration.