The role of suture cutout in the failure of meniscal root repair during the early post-operative period: a biomechanical study
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To assess the role of suture cutout in the mechanics of failure of the repaired posterior meniscal root during the early post-operative period when using sutures of different shape.
Twenty medial porcine menisci were randomized in two groups depending on the suture shape used to repair the posterior root: thread or tape. The sutured menisci were subjected to cyclic loading (1000 cycles, (10, 30) N) followed by load-to-failure testing. Residual displacements, stiffness, and ultimate failure load were determined. During tests, the tissue-suture interface was recorded using a high-resolution camera.
In cyclic tests, cutout progression at the suture insertion points was not observed for any specimen of either group and no differences in residual displacements were found between use of thread or tape. In load-to-failure tests, suture cutout started in all menisci at a load close to the ultimate failure and all specimens failed by suture pullout. Suture tape had a greater ultimate load with no other differences.
In a porcine model of a repaired posterior meniscal root subjected to cyclic loads representative of current rehabilitation protocols in the early post-operative period under restricted loading conditions, suture cutout was not found as a main source of permanent root displacement when using suture thread or tape. Suture cutout progression started at high loading levels close to the ultimate load of the construct. Tape, with a meniscus-suture contact area larger than thread, produced higher ultimate load.
KeywordsMeniscal root tear Transtibial pullout repair Meniscus-suture interface Suture cutout Permanent displacement
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 2.Seo JH, Li G, Shetty GM et al (2009) Effect of repair of radial tears at the root of the posterior horn of the medial meniscus with the pullout suture technique: a biomechanical study using porcine knees. Arthroscopy 25(11):1281–1287. https://doi.org/10.1016/j.arthro.2009.05.014 CrossRefPubMedGoogle Scholar
- 3.Padalecki JR, Jansson KS, Smith SD et al (2014) Biomechanical consequences of a complete radial tear adjacent to the medial meniscus posterior root attachment site: in situ pull-out repair restores derangement of joint mechanics. Am J Sports Med 42(3):699–707. https://doi.org/10.1177/0363546513499314 CrossRefPubMedGoogle Scholar
- 4.Forkel P, Herbort M, Sprenker F et al (2014) The biomechanical effect of a lateral meniscus posterior root tear with and without damage to the meniscofemoral ligament: efficacy of different repair techniques. Arthroscopy 30(7):833–840. https://doi.org/10.1016/j.arthro.2014.02.040 CrossRefPubMedGoogle Scholar
- 5.LaPrade CM, Jansson KS, Dornan G et al (2014) Altered tibiofemoral contact mechanics due to lateral meniscus posterior horn root avulsions and radial tears can be restored with in situ pull-out suture repairs. J Bone Joint Surg Am 96(6):471–479. https://doi.org/10.2106/JBJS.L.01252 CrossRefPubMedGoogle Scholar
- 6.Perez-Blanca A, Espejo-Baena A, Amat TD et al (2016) Comparative biomechanical study on contact alterations after lateral meniscus posterior root avulsion, transosseous reinsertion, and total meniscectomy. Arthroscopy 32(4):624–633. https://doi.org/10.1016/j.arthro.2015.08.040 CrossRefPubMedGoogle Scholar
- 10.Feucht MJ, Kühle J, Bode G et al (2015) Arthroscopic transtibial pullout repair for posterior medial meniscus root tears: a systematic review of clinical, radiographic, and second-look arthroscopic results. Arthorscopy 31(19):1808–1816. https://doi.org/10.1016/j.arthro.2015.03.022 CrossRefGoogle Scholar
- 12.Feucht MJ, Grande E, Brunhuber J, Rosenstiel N, Burgkart R, Imhoff AB, Braun S (2014) Biomechanical comparison between suture anchor and transtibial pull-out repair for posterior medial meniscus root tears. Am J Sports Med 42(1):187–193. https://doi.org/10.1177/0363546513502946 CrossRefPubMedGoogle Scholar
- 22.Feucht MJ, Grande E, Brunhuber J et al (2015) Biomechanical evaluation of different suture materials for arthroscopic transtibial pull-out repair of posterior meniscus root tears. Knee Surg Sports Traumatol Arthrosc 23(1):132–139. https://doi.org/10.1007/s00167-013-2656-z CrossRefPubMedGoogle Scholar