A Biomechanical Analysis of Meniscal Repair Techniques

Rankin, Christopher C.; Lintner, David M.; Noble, Philip C.; Paravic, Vibor; Greer, Erin

doi:10.1177/03635465020300040801

Cited by 106 publications

(71 citation statements)

References 24 publications

(27 reference statements)

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“…The higher pullout strength of vertical sutures found in this study is consistent with findings of various previous studies. 5,9,[11][12][13][14]19,29,35,37,44 In accordance with other studies, the pullout strength of rigid meniscus anchors (10-mm Meniscus Arrow, 48.8 ± 1.1 N) was inferior to vertical and horizontal suture repair, but there was no significant difference from the flexible RapidLoc repair system (45.2 ± 1.4 N). AlbrechtOlsen et al 3 reported a mean pullout strength of 53 N (range, 42-65 N) for the 13-mm Meniscus Arrow in a bovine model; Arnoczky and Lavagnino 5 found a pullout strength of 57.7 ± 13.8 N in a bovine meniscus; and Becker et al 13 reported a pullout strength of 32.7 N using a human model.…”

Section: Discussionsupporting

confidence: 89%

“…In this study, 60 fresh-frozen lateral bovine menisci were used as described by Rankin et al, 37 Boenisch et al, 14 and Arnoczky et al 5,8 The mean age of the animals was 28 weeks ± 2 weeks. Material properties of bovine menisci have been described by Proctor et al 36 The menisci were dissected free, leaving the adhering capsule intact, and stored at -20°C until 5 hours before testing.…”

Section: Biomechanical Modelmentioning

confidence: 99%

“…17,28 Of concern is the significantly lower load-tofailure strength for these devices when compared to conventional vertical sutures. 5,9,[11][12][13][14]19,29,35,37,44 Complications from these devices include migration into the subcutaneous tissue 28 with the risk of neurological injury, loosening, 28 and articular cartilage damage. 4,41 To overcome these disadvantages, new all-inside fixation techniques using anchors connected to suture material have been developed (FastT-Fix, Smith & Nephew, Andover, Mass; RapidLoc, Ethicon, Mitek Division, Norderstedt, Germany).…”

mentioning

confidence: 99%

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Initial Fixation Strength of Flexible All-Inside Meniscus Suture Anchors in Comparison to Conventional Suture Technique and Rigid Anchors

et al. 2004

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The menisci are mobile joint surfaces, and they cover approximately 70% of the tibial plateau. 20 They play an important role in the load transmission, shock absorption, lubrication, passive stabilization, and load transmission of the knee. 20,21,34,36 Several clinical long-term studies have shown that total or partial meniscectomy may lead to cartilage degeneration and osteoarthritis. 18,22,45 When faced with these detrimental effects of meniscectomy, the desire to preserve the menisci is easy to understand.Repair should be considered depending on the type and the location of the meniscal tear. Background: The newest generation of meniscus repair devices is designed to combine the benefits of the all-inside technique with the biomechanical properties of sutures.

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Section: Discussionsupporting

confidence: 89%

Section: Biomechanical Modelmentioning

confidence: 99%

mentioning

confidence: 99%

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Initial Fixation Strength of Flexible All-Inside Meniscus Suture Anchors in Comparison to Conventional Suture Technique and Rigid Anchors

et al. 2004

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“…5,9,17,35,78,80,81 Vertical sutures are superior to both horizontal sutures and meniscus arrows in mean load-to-failure values. 4,16,52,78 The superior strength of vertical sutures is hypothesized to be due to the perpendicular orientation to the circumferential collagen bundles of the meniscus. 52 We have previously described the operative techniques for meniscus repair of various types of tears in detail.…”

Section: Operative Techniquesmentioning

confidence: 99%

“…4,16,52,78 The superior strength of vertical sutures is hypothesized to be due to the perpendicular orientation to the circumferential collagen bundles of the meniscus. 52 We have previously described the operative techniques for meniscus repair of various types of tears in detail. 40 Diagnostic arthroscopy is first performed and the meniscus tear analyzed according to its location, type, and size.…”

Section: Operative Techniquesmentioning

confidence: 99%

Meniscus Repair and Transplantation: A Comprehensive Update

Noyes¹,

Heckmann²,

Barber-Westin³

2012

Journal of Orthopaedic & Sports Physical Therapy

101

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Synopsis Preservation of meniscal tissue is paramount for long-term joint function, especially in younger patients who are athletically active. Many studies have reported encouraging results following repair of meniscus tears for both simple longitudinal tears located in the periphery and complex multiplanar tears that extend into the central third avascular region. This operation is usually indicated in active patients who have tibiofemoral joint line pain and are less than 50 years of age. However, not all meniscus tears are repairable, especially if considerable damage has occurred. In select patients, meniscus transplantation may restore partial load-bearing meniscus function, decrease symptoms, and provide chondroprotective effects. The initial postoperative goal after both meniscus repair and transplantation is to prevent excessive weight bearing, as high compressive and shear forces can disrupt healing meniscus repair sites and transplants. Immediate knee motion and muscle strengthening are initiated the day after surgery. Variations are built into the rehabilitation protocol according to the type, location, and size of the meniscus repair, if concomitant procedures are performed, and if articular cartilage damage is present. Meniscus repairs located in the periphery heal rapidly, whereas complex multiplanar repairs tend to heal more slowly and require greater caution. The authors have reported the efficacy of the rehabilitation programs and the results of meniscus repair and transplantation in many studies. J Orthop Sports Phys Ther 2012;42(3):274–290, Epub 4 September 2011. doi:10.2519/jospt.2012.3588

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Ontogeny of the meniscus in the anuran Xenopus laevis

Lazarte

Manzano

Sanchez

et al. 2022

The Anatomical Record

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The anuran knee joint is subjected to the jump, one of the tetrapods' most demanding mechanical stresses. Consistent with this continuous effort, the knee of the anurans has a complex structure comparable to that of an amniote.Here, we describe the ontogeny of the Xenopus knee tissues and study the morphogenesis of the knee joint shape by performing a geometric morphometric analysis of specially selected anatomical structures: the menisci and the long bone epiphyses. A meniscus is a crescent-shaped fibrocartilaginous structure, with a triangular cross-section inserted between joints surfaces. A meniscus transmits load across the tibiofemoral joint by increasing congruity of the long bone epiphysis and decreasing the resulting stress exerted on the articular cartilage. We ask two questions: (1) what is the tissue composition along the ontogeny of the menisci of a swimming frog? (2) How do the menisci acquire the shape that will allow their adjustment? We studied the structures and tissue ontogeny of the knee of several specimens of Xenopus laevis and evaluated the congruity of the knee structures across the species ontogeny. Histological sections showed that the cavitation process responsible for separating the menisci and the epiphyses seems to be pivotal in shaping the conformity of these structures and the long bone epiphyses of the hindlimbs. The geometric morphometric analysis allowed us to interpret three phases of differentiation associated with limb functionality. The characteristic shape of the meniscus appears early in the ontogeny of the knee, simultaneously with the epiphysis contours.

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A Biomechanical Analysis of Meniscal Repair Techniques

Abstract: Knowledge of biomechanical characteristics aids the surgeon in choosing the appropriate technique for each situation.

Cited by 106 publications

References 24 publications

Initial Fixation Strength of Flexible All-Inside Meniscus Suture Anchors in Comparison to Conventional Suture Technique and Rigid Anchors

Initial Fixation Strength of Flexible All-Inside Meniscus Suture Anchors in Comparison to Conventional Suture Technique and Rigid Anchors

Meniscus Repair and Transplantation: A Comprehensive Update

Ontogeny of the meniscus in the anuran Xenopus laevis

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