Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Am J Sports Med. 2012 Feb;40(2):414-8. doi: 10.1177/0363546511424395. Epub 2011 Oct 19.
Repair of complete radial meniscal tears is a key to restoring the mechanical integrity necessary to maintain hoop tension in the meniscus. The primary stability of the meniscal repair is one of the most important factors for meniscal healing, but the biomechanical structural properties of different repair techniques for complete radial meniscal tears remain unknown.
Our novel cross-suture technique with suturing oblique to the collagen fibrils of the meniscus will yield better fixation than the standard double horizontal suture technique with suturing parallel to the collagen fibrils in the meniscus.
Controlled laboratory study.
Biomechanical investigation was performed on 40 fresh human menisci (2 groups of 20 menisci each) from patients who underwent total knee arthroplasty. In the cross-suture technique group (group A), the sutures crossed over 5 mm from the tear and 5 mm and 10 mm from the rim. In the double horizontal suture technique group (group B), the sutures were parallel and had the same attachment points as group A. The specimens were cyclically loaded 500 times between 5 and 30 N and then loaded to failure after completion of the cyclic load testing.
Compared with the double horizontal suture group, the cross-suture group had a significantly higher ultimate failure load (78.96 ± 19.27 N vs 68.16 ± 12.92 N; P < .05), significantly greater stiffness (8.01 ± 1.54 N/mm vs 6.46 ± 1.12 N/mm; P < .05), and significantly lower displacement (5.74 ± 1.84 mm vs 8.56 ± 2.39 mm; P < .05) after a 500-cycle loading protocol.
Our cross-suture technique significantly improved the structural properties of the repaired complete radial meniscal tears.
The cross-suture technique for repair of radial meniscal tears provides high stability and could be a promising solution in young and in active patients.
修复完全性放射状半月板撕裂是恢复维持半月板环张力所需的机械完整性的关键。半月板修复的主要稳定性是半月板愈合最重要的因素之一，但完全性放射状半月板撕裂不同修复技术的生物力学结构特性尚不清楚。
我们的新型斜交半月板胶原纤维缝线技术比半月板胶原纤维平行缝线的标准双水平缝线技术具有更好的固定效果。
对照实验室研究。
对 40 例接受全膝关节置换术的患者的新鲜半月板（每组 20 个半月板）进行生物力学研究。在交叉缝线技术组（A 组）中，缝线从撕裂处跨越 5mm，从边缘跨越 5mm 和 10mm。在双水平缝线技术组（B 组）中，缝线与 A 组平行且具有相同的附着点。在完成循环加载测试后，将标本在 5 至 30N 之间循环加载 500 次，然后进行失效加载。
与双水平缝线组相比，交叉缝线组的最终失效载荷显著更高（78.96 ± 19.27N 比 68.16 ± 12.92N；P <.05），刚度显著更高（8.01 ± 1.54N/mm 比 6.46 ± 1.12N/mm；P <.05），位移显著更小（5.74 ± 1.84mm 比 8.56 ± 2.39mm；P <.05）。
我们的交叉缝线技术显著改善了修复后的完全性放射状半月板撕裂的结构性能。
放射状半月板撕裂的交叉缝线修复技术提供了高度的稳定性，对于年轻和活跃的患者可能是一种有前途的解决方案。
