ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #1008

 

Comparison of Tibiofemoral Contact Mechanics After Various Transtibial and All-Inside Fixation Techniques for Medial Meniscus Posterior Root Radial Tears in a Porcine Mode

Kyu Sung Chung, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Choong-Hyeok Choi, MD, PhD, Seoul KOREA, REPUBLIC OF
Tae-Soo Bae, PhD, Kyunggi KOREA, REPUBLIC OF
Jeong-Ku Ha, MD, Seoul KOREA, REPUBLIC OF
Ho-Jong Ra, MD, PhD, Gangneung, Gangwon KOREA, REPUBLIC OF
Joon-Ho Wang, MD, PhD, Seoul KOREA, REPUBLIC OF
Jin-Goo Kim, MD, PhD, Goynag-Si, Gyeonggi-do KOREA, REPUBLIC OF

Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University, Seoul, KOREA, REPUBLIC OF

FDA Status Cleared

Summary

Our results in a porcine model suggest that fixation can restore tibiofemoral contact mechanics in MMPRT and that fixation with a locking mechanism leads to superior biomechanical properties.

Abstract

Objects:
This experimental study aimed to compare tibiofemoral contact mechanics following different fixation methods for medial meniscus posterior root radial tears (MMPRTs) in a porcine model.

Methods

Seven fresh knees of mature pigs were used. Each knee was tested under five conditions: normal knee, MMPRT, pullout fixation with simple sutures, modified Mason-Allen sutures, and all-inside fixation using FastfixTM360. Peak contact pressure and contact surface area were evaluated using a capacitive pressure sensor positioned between the meniscus and tibial plateau, under 1000-N compression force to assess tibiofemoral contact mechanics, at different flexion angles (0o, 30o, 60o, 90o).

Results

Peak contact pressure was significantly higher in MMPRTs than in normal knees (P=0.018). While peak contact pressure decreased significantly after fixation at all flexion angles (P=0.031), it never recovered to the values noted in the normal meniscus. No difference was observed among fixation groups (P=0.054). Contact surface area was significantly lower in MMPRTs than in the normal meniscus (P=0.018), increased significantly after fixation at all flexion angles (P=0.018), but did not recover to within normal limits. For all flexion angles except 60o, contact surface area was significantly higher for fixation with Mason-Allen sutures than for fixation with simple sutures or all-inside fixation (P=0.027). At 90o of flexion, contact surface area was significantly better for fixation with simple sutures than for all-inside fixation (P=0.031).

Conclusions

Peak contact pressure and contact surface area improved significantly following fixation, regardless of the fixation method, but did not recover to the levels noted in the normal meniscus following any type of fixation. Among the fixation methods evaluated in this time zero study, fixation using modified Mason-Allen sutures provided superior contact surface area compared to those noted after fixation using simple sutures or all-inside fixation, except at 60o of flexion.