The effect of inclination angle on the strength of vertical mattress configuration for meniscus repair.

PURPOSE: Vertical mattress configuration is the strongest of all other configurations and the repairing devices of meniscus repair. The purpose was whether increasing the inclination angle between two strands of the vertical mattress configuration by increasing the amount of meniscus tissue captured would enhance the initial strength of the construction.

METHODS: A 2-cm long anteroposterior vertical longitudinal incision was created in two groups of bovine medial menisci. In the first group, the distance between the two vertical suture strands and the vertical horizontal sutures on the capsular side of the meniscal lesion was 2 mm (Group 1). In the second group, the distance was 5 mm (Group 2). The following repair specimens underwent cyclic loading prior to loading the failure testing. The endpoints included ultimate failure load (N), stiffness (N/mm) and cyclic displacement (mm) after the 100 cycles and the mode of failure.

RESULTS: Group 1 (2 mm) (90.7 (±19.9) N) had lower ultimate load than Group 2 (5 mm) (120.8 (±24.5)) (P < 0.05). Stiffness and displacements during the cycling were not different between the groups (n.s.). All specimens failed by suture rupture.

CONCLUSION: Increased inclination angle with increased distance between the two vertical suture strands on the capsular side of the meniscal lesion resulted in higher failure load compared to control group with lower inclination angle and distance on the capsular side.