Andreas B. Imhoff, Department of Orthopaedic Sports Medicine, Technical University Munich, Ismaninger Straße 22, 81675 Munich, Germany.
Am J Sports Med. 2014 Jan;42(1):187-93. doi: 10.1177/0363546513502946. Epub 2013 Sep 9.
Posterior medial meniscus root (PMMR) tears have a serious effect on knee joint biomechanics. Currently used techniques for refixation of the PMMR include the transtibial pull-out repair (TP) and suture anchor repair (SA). These techniques have not been compared biomechanically.
The SA technique provides superior biomechanical properties compared with the TP technique.
Controlled laboratory study.
A total of 24 fresh-frozen porcine tibiae with attached intact medial menisci were used. The specimens were randomly assigned to 3 groups (8 specimens each). A standardized PMMR tear was created in 16 specimens. Refixation of the PMMR was performed by either the TP or SA technique. The native PMMR was left intact in 8 specimens. All specimens were subjected to cyclic loading followed by load-to-failure testing. Displacement after 100, 500, and 1000 cycles; maximum load to failure; stiffness; and displacement at failure were recorded.
Both repair techniques showed a significantly higher displacement during cyclic loading and a significantly lower maximum load and stiffness during load-to-failure testing compared with the native PMMR (P < .05). The SA technique showed a significantly lower displacement after 100, 500, and 1000 cycles (P < .001) and a significantly higher stiffness (P = .016) compared with the TP technique. Maximum load did not differ significantly between the SA and TP techniques (P = .027, Bonferroni adjustment). No significant difference between the 3 groups was observed for displacement at failure (P > .05).
The SA technique provided superior biomechanical properties compared with the TP technique. Both repair techniques did not reach the strength of the native PMMR.
The favorable biomechanical properties of the SA technique might be beneficial for healing of the repaired PMMR and restoration of meniscus function. Because of inferior time zero stability compared with the native PMMR, slow rehabilitation is recommended after meniscus root repair.
后内侧半月板根（PMMR）撕裂对膝关节生物力学有严重影响。目前用于固定 PMMR 的技术包括经胫骨拉出修复（TP）和缝线锚修复（SA）。这些技术尚未进行生物力学比较。
SA 技术提供优于 TP 技术的生物力学性能。
对照实验室研究。
使用 24 个附有完整内侧半月板的新鲜冷冻猪胫骨。标本随机分为 3 组（每组 8 个标本）。16 个标本中创建了标准化的 PMMR 撕裂。通过 TP 或 SA 技术固定 PMMR。8 个标本保留完整的 PMMR。所有标本均进行循环加载，然后进行失效载荷测试。记录 100、500 和 1000 个循环后的位移；失效载荷下的最大载荷；刚度；以及失效时的位移。
与天然 PMMR 相比，两种修复技术在循环加载时表现出明显更高的位移，在失效载荷测试时表现出明显更低的最大载荷和刚度（P <.05）。与 TP 技术相比，SA 技术在 100、500 和 1000 个循环后表现出明显更低的位移（P <.001）和更高的刚度（P =.016）。SA 和 TP 技术之间的最大载荷无显著差异（P =.027，Bonferroni 调整）。3 组之间的失效时位移无显著差异（P >.05）。
与 TP 技术相比，SA 技术提供了更好的生物力学性能。两种修复技术均未达到天然 PMMR 的强度。
SA 技术的有利生物力学性能可能有利于修复的 PMMR 愈合和半月板功能的恢复。由于与天然 PMMR 相比，零时稳定性较差，建议在半月板根修复后进行缓慢康复。
