Load to failure testing of new meniscal repair devices

Abstract

Purpose: New all-inside meniscal repair devices include those combining sutures with anchors and that allow for an “adjustable” repair. This study’s purpose was to compare the failure strength of new meniscal repair devices with suture repairs. Type of Study: Experimental laboratory biomechanical study. Methods: A single repair was placed in a vertical longitudinal peripheral tear made in fresh adult porcine menisci. Group 1 had a vertically oriented suture using the FasT-Fix (Smith & Nephew Endoscopy, Andover, MA) device. Group 2 had a horizontally oriented mattress suture using the FasT-Fix device. Group 3 had a repair using 2 Arthrex (Naples, FL) meniscal darts. The Group 4 repair used a RapidLoc (Mitek Surgical Products, Westwood, MA) device. The Group 5 repair used the Arthrotek meniscal screw (Biomet, Warsaw, IN). Group 6 had a single vertical suture, and group 7 a single horizontal suture, both of 2-0 Mersilene (Ethicon, Somerville, NJ). Load to failure testing was performed. Results: The vertical FasT-Fix suture had a mean load to failure of 70.9 N (1 SD ± 33). The horizontal FasT-Fix suture had a mean load to failure of 72.1 N (± 23.5). The double Dart repair had a mean load to failure of 61.7 N (± 19). The RapidLoc repair had a mean load to failure of 43.28 N (± 3.98). The Arthrotek meniscal screw repair had a mean load to failure of 28.09 N (± 7.93). Failure occurred with device pullout of the inner rim (9 of 10) for the Darts, device pullout of the inner rim (6 of 10) and pullout of the outer rim (4 of 10) for the Arthrotek screw, and suture breakage for the FasT-Fix and the RapidLoc devices. The vertical sutures’ mean load to failure was 80.43 N (± 8.5), and all 13 failed by suture breaking. The horizontal sutures’ mean failure load was 55.9 N (± 18.8), and failure was by both suture breaking (6 of 10) and pulling through the meniscal tissue (4 of 10). Conclusions: Some of the newer meniscal repair devices show improved loads to failure over earlier generations.