Abstract
BackgroundIn the meniscal repair procedures, a high ultimate load capacity and low cyclic creep at the repair site are favorable and lead to good biological incorporation of the tear site after surgery. Previous biomechanical tensile tests of the meniscal sutures have identified the suture knot as the weakest point. We hypothesized that the strength of a suture knot depends on the suture shape, and therefore, we compared three differently shaped suture materials composed of the same material and quantity per length. The purpose of this study was to determine whether a novel flat and wide repair material (FWRM), which consists of braided multi-threads that are cross-sectionally flat and wide, improves the ultimate load of knot breakage in a biomechanical experiment using a porcine trans-capsular meniscal repair model.MethodsEighteen fresh-frozen porcine knees (n = 6 in each group) were used. A longitudinal tear in the middle segment of the medial meniscus was created and repaired with a trans-capsular inside-out method using the following suture materials: No. 2–0 braided polyester conventional suture, hollow suture, and FWRM. After the separation of the inner segment of the meniscus with leaving, the suture stability of the repaired menisci was biomechanically analyzed with a video camera system for widening after a cyclic load between 5 and 20 N was applied 300 times. Ultimate failure load and stiffness at 5 mm/ min were also analyzed.ResultsWe found no significant difference in suture widening after cyclic load tests [conventional suture, mean 0.51 mm (S.D. 0.39 mm); hollow suture, mean 0.23 mm (S.D. 0.11 mm); and FWRM, mean 0.54 mm (S.D. 0.08 mm)]. The failure mode in all specimens was knot breakage. Compared with those of the other groups, the ultimate failure load of FWRM was statistically significantly higher in the load-to-failure tests (conventional suture, mean 58.8 N [S.D. 8.25 N]; hollow suture, mean 79.4 N [S.D. 10.2 N]; and FWRM, mean 97.4 N [S.D. 3.65 N]; p < 0.05).ConclusionFWRM improves the ultimate load of knot breakage without altering stability. This material may contribute to safe and stable meniscus repair.
Highlights
In the meniscal repair procedures, a high ultimate load capacity and low cyclic creep at the repair site are favorable and lead to good biological incorporation of the tear site after surgery
The effectiveness of a meniscal suture depends on adequate biomechanical stability at the repair site, the biological incorporation of the tear site, and the healing capacity of the meniscus (Post et al 1997; Seil et al 2000)
The results of biomechanical tensile tests of meniscal sutures used with the inside-out technique have shown that the suture knot is the weakest point, and knot breakage occurs during ultimate failure load testing (Asik and Sener 2002; Barber et al 2009; Barber and Stone, 1985; Brucker et al 2010; Post et al 1997; Seil et al 2000; Zantop et al 2005)
Summary
In the meniscal repair procedures, a high ultimate load capacity and low cyclic creep at the repair site are favorable and lead to good biological incorporation of the tear site after surgery. In the meniscal repair procedures, stability at the repair site under a high ultimate tensile load and a low cyclic creep are favorable and leads to good biological incorporation of the tear site after surgery. The results of biomechanical tensile tests of meniscal sutures used with the inside-out technique have shown that the suture knot is the weakest point, and knot breakage occurs during ultimate failure load testing (Asik and Sener 2002; Barber et al 2009; Barber and Stone, 1985; Brucker et al 2010; Post et al 1997; Seil et al 2000; Zantop et al 2005). These results prompted us to strengthen the ultimate load of the knot to achieve better meniscal repair results using the inside-out technique
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
