The effect of suture type on meniscus repair. A clinical analysis

To test the hypothesis that use of permanent suture for meniscus repair allows longer, more stable fixation and more complete healing than absorbable suture, 89 patients (90 meniscus repairs) undergoing repair between 1990 and 1993 were evaluated. Eight patients were lost to follow-up, leaving 81 patients with 82 meniscal repairs. All patients underwent meniscus repair with either absorbable or permanent suture and were re-evaluated at an average of 24.1 months follow-up. The tears were within 5 mm of the peripheral meniscal rim and communicated with the peripheral blood supply (either red-red or red-white zone). Group 1 (absorbable suture) was comprised of 50 patients (38 males and 12 females; 19 right and 31 left knees). There were 36 medial and 14 lateral repairs. Group 2 (permanent suture) was comprised of 31 patients with 32 meniscus repairs (23 males and 8 females; 17 right knees and 14 left knees). There were 23 medial and 9 lateral meniscus repairs. Follow-up consisted of objective (clinical examination, range of motion, McMurray test, detectable swelling, locking, and joint-line tenderness) and subjective evaluations (15 question series of visual analog scales). Success or failure of the meniscal repair was based on the degree of symptoms present at follow-up. Group 1 had 9 failures, while Group 2 had none. All of the failures were rescoped and required additional surgical procedures. Group 1 had higher scores on all subjective questions. Data were analyzed using the two-sample t-test and the chi-squared test. The absolute failure rate was statistically significant. In this study, menisci repaired with permanent sutures had a lower incidence of clinical symptoms and a much lower failure rate. Thus, permanent suture is recommended for meniscus repair as it appears to allow for longer and more stable fixation, permitting more complete maturation and remodeling of the meniscus.