Meniscal repair using large diameter horizontal sutures increases fixation strength: an in vitro study

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Sports Medicine

Background:

• Meniscal tears are common knee injuries requiring surgical repair.
• The choice of suture material and diameter significantly impacts the mechanical stability of meniscal repairs.
• Understanding the biomechanical properties of different suture configurations is crucial for optimizing surgical outcomes.

Purpose of the Study:

• To compare the mechanical characteristics of meniscal repair fixation using horizontal sutures of two different diameters (#2-0 and #2 Fiberwire).
• To evaluate suture performance under submaximal cyclic loading and load-to-failure conditions.

Main Methods:

• Bovine medial menisci were used, with a 2-cm longitudinal incision created.
• Repairs were performed using either #2-0 (Group 1) or #2 (Group 2) Fiberwire suture.
• Specimens underwent cyclic testing (5-50 N at 1 Hz for 500 cycles) and load-to-failure testing (5 mm/min crosshead speed).

Main Results:

• Group 2 (larger diameter suture) exhibited significantly greater load at failure (132.1 ± 54.4 N) compared to Group 1 (91.9 ± 26.2 N) (P = 0.02).
• Group 2 also showed significantly greater stiffness (47.1 ± 8.3 N/mm) than Group 1 (38.5 ± 10.2 N/mm) (P = 0.03).
• Failure mode in all specimens was suture pull-through, indicating suture strength and tissue interface limitations.

Conclusions:

• Larger diameter sutures (#2 Fiberwire) provide superior mechanical fixation for meniscal repairs compared to smaller diameter sutures (#2-0 Fiberwire).
• The findings suggest that utilizing larger diameter sutures in horizontal meniscal repair techniques can enhance repair strength and stability.