Meniscal repair with the MaxFire device: a cadaveric study

To use a cadaver model to evaluate an all-inside meniscal repair device (MaxFire).

Six fresh-frozen cadaveric knees (ages 30-84 years) without evidence of prior surgery were used for this study. The knees were rigidly mounted and arthroscopy performed using standard anteromedial and anterolateral portals. Four MaxFire devices were placed into the medial and lateral meniscus according to the technique provided by the manufacturer. The devices were placed in a vertical or horizontal mattress fashion systematically from posterior to anterior. Implants were placed from either the ipsilateral- or contralateral-portal at the discretion of each surgeon. Placement into the medial meniscus was performed with the knee in approximately 10° of flexion and into the lateral meniscus in 45° of flexion.

In all, 54 MaxFire devices were placed. Twenty-six devices were used medially, and 28 laterally. Forty-five (83%) were placed successfully. Of those, 3 (7%) were placed in a "top hat" fashion. The nine failures (17%) were related to final device tensioning. Three of the sutures broke, one suture would not reduce, and three implants pulled out of the meniscus. The devices were successfully removed arthroscopically with a grasper or oscillating shaver. Pulling of implants out of menisci occurred in degenerative knees with degenerative meniscal tissue and did not occur with healthy appearing menisci.

The MaxFire device is easy to use, has a low risk of complications, and can be inserted expeditiously by arthroscopy.