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

Abstract

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.

Meniscus Repair and Transplantation: A Comprehensive Update

“…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.…”

Die arthroskopische Meniskusnaht

“…Des Weiteren kam es durch Wanderung der Implantate zu Weichteilirritationen, die in einigen Fällen sogar zu Läsionen an Nerven und Gefäßen führten [15]. Biomechanische Studien haben gezeigt, dass die Innen-Innen-Meniskusrefixationssysteme konventionellen Nahttechniken hinsichtlich ihrer Primärstabili-tät deutlich unterlegen sind [30,31]. Ein weiterer gravierender Nachteil von Innen-Innen-Refixationssystemen sind deren hohe Kosten.…”

“…In addition, soft-tissue irritation may occur due to migration of the implants and has even caused lesions of the nerves and vessels in some cases [15]. Biomechanical studies have shown that the all-inside meniscal repair systems are clearly inferior to conventional suture techniques with regard to their primary stability [30,31]. Another serious disadvantage is the great expense of the all-inside repair systems.…”

“…Vertikale Nähte haben im Vergleich zur horizontalen Naht eine höhere Festigkeit [14,30,31]. Da der Hauptteil der Kollagenfibrillen innerhalb der Menisken zirkulär verläuft [21], werden von vertikalen Näh-ten mehr Kollagenfibrillenbündel gefasst.…”

“…Vertical sutures have greater holding strength than horizontal sutures [14,30,31]. Since most of the collagen fibrils run in a circular fashion within the menisci [21], more collagen fibril bundles are grasped by vertical sutures.…”