Biomechanical properties under cyclic loading of seven meniscus repair techniques

The purpose of the current study was to obtain additional information about the biomechanical behavior of different fixation techniques for meniscus repair using recently developed biodegradable implants and suture repair techniques. The posterior horns of human menisci were used to investigate the meniscus repair construct of the Arrow, Screw, Stinger, Fastener, T-fix, and horizontal and vertical mattress suture. A 20 mm-longitudinal incision was made in the meniscus, similar to a bucket handle lesion, 3 mm from the meniscosynovial rim and was repaired. One hundred cycles between 5 N and 15 N were done using a tension load machine with a loading rate of 10 N/second. The stiffness, displacement, and pullout strength were examined. The significantly highest stiffness was found for the vertical mattress suture (17.1 N/mm) and Stinger (15 N/mm) followed by the Arrow (13.7 N/mm), T-fix (10.5 N/mm), and horizontal mattress suture (10 N/mm). Superior load to failure was obtained for the suture repair in comparison with the biodegradable implants. Despite the lower pullout strength of biodegradable implants, similar stiffnesses were found for the Stinger and Arrow in comparison with the mattress suture technique. These techniques provide the most rigid fixation that is essential for tissue healing.