Biomechanical Comparison of Arthroscopic Repair Constructs for Radial Tears of the Meniscus
| Autor: | Adam W. Anz, Charles Milchteim, Eric A. Branch, Justin D. Saliman, Wei Liu, Bradley S. Aspey |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Physical Therapy Sports Therapy and Rehabilitation Knee Injuries Meniscus (anatomy) Lacerations Menisci Tibial Arthroscopy Suture (anatomy) Stress Physiological Cadaver medicine Humans Orthopedics and Sports Medicine Clinical scenario Rupture Wound Healing Sutures medicine.diagnostic_test business.industry Suture Techniques Stiffness Anatomy Middle Aged Biomechanical Phenomena Tibial Meniscus Injuries medicine.anatomical_structure Tears Female medicine.symptom Cadaveric spasm business |
| Zdroj: | The American Journal of Sports Medicine. 43:2270-2276 |
| ISSN: | 1552-3365 0363-5465 |
| DOI: | 10.1177/0363546515591994 |
| Popis: | Background: Radial tears of the meniscus represent a challenging clinical scenario because benign neglect and partial meniscectomy have both been shown to have negative biomechanical and long-term clinical consequences. Hypothesis: Complex suture repair constructs have higher failure loads and stiffness values compared with simple constructs. Study Design: Controlled laboratory study. Methods: After radial transection of human cadaveric menisci, simulated tears were repaired arthroscopically by use of 1 of 4 repair constructs: (1) 2 inside-out horizontal sutures, (2) 2 all-inside horizontal sutures, (3) an all-inside Mason-Allen construct consisting of 4 sutures, or (4) an all-inside construct consisting of a figure-of-8 suture plus 1 horizontal suture. Meniscus specimens were harvested and tested to failure on an Instron machine. The Kruskal-Wallis test was used to evaluate for significance of maximal failure load and stiffness between groups. Results: The mean maximum failure loads were 64 ± 20 N (inside-out horizontal construct), 75 ± 16 N (all-inside horizontal construct), 86 ± 19 N (Mason-Allen construct), and 113 ± 22 N (figure-of-8 plus horizontal construct). Interconstruct comparison revealed a statistically significant difference between the figure-of-8 plus horizontal construct and all 3 remaining constructs ( P < .02) as well as the Mason-Allen construct when compared with the inside-out horizontal construct ( P < .01). Statistical significance was not found between the all-inside horizontal construct and the Mason-Allen construct or between the all-inside horizontal construct and the inside-out horizontal construct ( P = .2 and .7, respectively). Stiffness values were lower for the inside-out construct compared with the all-inside constructs ( P < .05). Conclusion: Complex all-inside repair constructs had significantly higher failure loads than a conventional, simple inside-out suture repair construct for repair of radial meniscal tears. Stiffness values among the all-inside groups were greater than those for the inside-out group. Clinical Relevance: Arthroscopic techniques are presented to produce stronger radial meniscal tear repairs. |
| Databáze: | OpenAIRE |
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