Cyclic testing of flexible all-inside meniscus suture anchors: biomechanical analysis

Thore Zantop, Ann K Eggers, Volker Musahl, Andre Weimann, Wolf Petersen
American Journal of Sports Medicine 2005, 33 (3): 388-94

BACKGROUND: Flexible meniscus repair devices are designed to combine the benefits of rigid all-inside meniscus anchors with the biomechanical properties of sutures.

HYPOTHESIS: Stiffness and pull-out strength of flexible all-inside suture anchors and conventional sutures under cyclic loading conditions will be comparable.

STUDY DESIGN: Controlled laboratory study.

METHODS: In 50 fresh frozen bovine menisci, artificial meniscus lesions were repaired with different meniscus fixation techniques: horizontal and vertical FasT-Fix, RapidLoc, and horizontal and vertical 2-0 Ethibond sutures. The specimens were cycled 1000 times between 5 and 20 N and then loaded to failure.

RESULTS: All devices survived the cyclic loading protocol. There was no significant difference in the displacement between all repair techniques tested (horizontal FasT-Fix, 6.23 mm; vertical FasT-Fix, 5.34 mm; RapidLoc, 6.84 mm; horizontal 2-0 Ethibond, 6.03 mm; vertical 2-0 Ethibond, 5.61 mm (P > .05). Vertical and horizontal FasT-Fix suture anchors had a significantly higher stiffness and pull-out strength (94.1 N and 80.8 N, respectively) than did horizontal sutures (50.2 N) and RapidLoc devices (30.3 N) (P > .05).

CONCLUSIONS: In this study, flexible all-inside meniscus anchors (FasT-Fix) had higher pull-out strength than did conventional vertical suture techniques. Biomechanical characteristics of the flexible RapidLoc are comparable to those of horizontal sutures.

CLINICAL RELEVANCE: Flexible all-inside meniscus repair devices are an alternative to conventional suture techniques.

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