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Mechanical properties of bioabsorbable meniscal arrows as a function of tear location: an ex vivo experimental study
Mihir M Jani1, Matthew J Silva, Ron V Gregush
1Washington University, Department of Orthopaedic Surgery, St Louis, Missouri 63110, USA.
Background:
Ex vivo studies have established that arrow fixation of meniscal tears is inferior to vertical sutures and is dependent on arrow length, although the influence of tear location is not known.
Hypothesis:
Arrow length and tear location influence the mechanical properties of meniscal arrows.
Study Design:
Controlled laboratory study.
Methods:
A longitudinal incision was created either 2 mm or 7 mm from the periphery in 70 bovine medial menisci. Each was repaired with a meniscal arrow (10, 13, or 16 mm) or a single vertical suture and subjected to load-to-failure testing and video-graphic analysis.
Results:
Mode of failure (P <.0001), maximum force (P <.0001), stiffness (P <.01), 2-mm gap force (P <.03), and ultimate gap formation (P <.002) were all directly related to arrow length. Sixteen-mm arrows and suture exhibited similar, superior mechanical properties. Tear location significantly influenced properties of 10-mm and 16-mm but not 13-mm arrows. Ten-millimeter arrows displayed the worst performance.
Conclusions:
Mechanical properties of meniscal arrows depend on tear location and arrow length.
Clinical Relevance:
Sixteen-millimeter arrows are a possible alternative to suture for repair of central tears. Thirteen-millimeter arrows may be effective for central and peripheral tears. Ten-millimeter arrows should not be used.
