All-Inside Meniscal Repair Using a New Flexible, Tensionable Device (SS-37)

Abstract

investigators have demonstrated the crucial role that the meniscus plays in load transmission, shock absorption, joint stability, and improving nutrition to the articular surface. Techniques have evolved from early reports of open meniscal repair by DeHaven to modern all-inside repair. Meniscal repair using suture placed “inside-out” has become the gold standard to which other techniques are compared, with 10-year success rates of approximately 90% when performed with concurrent anterior cruciate ligament reconstruction (ACLR). Numerous all-inside devices have been developed to simplify meniscal repair by avoiding the need for a separate incision and thereby decreasing operative time and the risk of neurovascular injury. Although short-term success rates for one commonly used rigid all-inside device have ranged from 88% to 100%, long-term followup has revealed deteriorating outcomes, with a success rate of only 71%. In addition to lower success rates, the rigid “second generation” all-inside devices have been associated with inflammatory reaction, cyst formation, migration, breakage, and chondral injury. The newer “third generation” all-inside devices use suture to place compression across the tear and provide flexible fixation to help prevent chondral wear. One of these devices, the RapidLoc (Mitek, Westwood, Mass), uses either a 2-0 Ethibond or 2-0 Panacryl suture (DePuy Mitek Inc, Raynham, Mass) between a poly-L-lactic acid All-Inside Meniscal Repair Using a New Flexible, Tensionable Device