2017 ISAKOS Biennial Congress ePoster #1330
A Novel Technique for Repair of Posterior Medial Meniscus Root Tear: A Biomechanical Study Using Porcine Knees
Jia-Lin Wu, MD, MS, Taipei TAIWAN
Chan-Tsung Yang, PhD, Taipei TAIWAN
Chia-Ming Chang, MS, Taipei City TAIWAN
Shaobai Wang, PhD, Shanghai CHINA
Chian-Her Lee, MD, Taipei TAIWAN
Cheng-Kung Cheng , PhD, Taipei TAIWAN
Chih-Hwa Chen, MD, Prof., New Taipei City TAIWAN
Yu-Shu Lai, Ph.D, Taipei TAIWAN
Department of Orthopedics and Traumatology, School of Medicine, College of Medicine, Taipei Medical University; Department of Orthopedics, Taipei Medical University Hospital, TAIPEI, TAIWAN
FDA Status Cleared
Summary
This novel technique could provide an alternative choice for chronic medial meniscus root tear with severe loss of tissue substance or shortening of the meniscus root ligament, which will result in a difficulty in anatomic root repair.
Abstract
Background
Transtibial pull-out suture repair of posterior medial meniscus root (PMMR) tear has been shown to achieve good clinical outcome but the objective results were less promising. However, some studies showed that radial tears of the meniscus root area could leave a gap that has difficulties in surgical repair. Therefore, this study provides a new concept for surgeons dealing with these difficult-to-treat injuries.
Purpose/Hypothesis: Aim of the present study was to evaluate the biomechanical properties of a novel designed technique for repair of PMMR tear using tendon graft (TG) and hypothesized that the TG technique provides superior structural properties compared with the transtibial pullout suture repair (TPS) technique
Study Design: Controlled laboratory study.
Methods
A total of 12 porcine tibiae with attached intact medial meniscus root were used and were randomly assigned to 2 groups (6 specimens each). A standardized PMMR tear model was created in all specimens. For the TG, a harvested fresh flexor digitorum profundus tendon was passed through the created incision of meniscus with around 5 mm from the root tear region. For the TPS, a Modified Mason-Allen suture was created by No. 2 FiberWire. The tendon grafts and sutures were retrieved through the created bone tunnel and then fixed to the anterolateral cortex. All specimens were subjected to cyclic loading followed by load-to-failure testing. Displacement after 100, 500, and 1000 cycles; ultimate failure load; stiffness; and elongation at failure were recorded.
Results
The two techniques showed no significant differences in displacement after 100, 500, and 1000 cyclic loading test (P > .05). The TG technique had a significantly lower elongation but higher stiffness compared with the TPS (P < .05). The maximum load for TG was significantly lower than the TPS (P < .05). All specimens failed by suture or graft cutout of the meniscus.
Conclusion
The profitable biomechanical properties of the TG technique such as less elongation and higher stiffness might be beneficial for postoperative meniscus to bone healing but slow rehabilitation program is recommended.