Laboratory of Clinical Biomechanics, Málaga, Spain.
Department Mechanical Engineering, Universidad de Málaga, Andalucía Tech, Málaga, Spain.
Sci Rep. 2020 Feb 4;10(1):1748. doi: 10.1038/s41598-020-58656-6.
The importance of meniscal root integrity to preserve contact load distribution and stability at the knee joint is recognised. Transosseous suture technique is commonly used to repair meniscal root tears. However, clinical results are not completely satisfactory. Specifically, concern exists about the development of substantial displacements at the repaired root. This study aims to assess if the use of a post-insertion tensioning knotless-anchor at the distal exit of the tibial tunnel improves time-zero biomechanical properties of the transtibial repair compared to knotting sutures over a cortical button. Twenty porcine tibia with detached posterior medial meniscal roots were randomized into two groups depending on the method to fix the sutures after root repair: knotless-anchor (KA) or suture-button (SB). Specimens underwent cyclic and load-to-failure testing. Group KA showed significantly smaller residual root displacements after low-level repetitive loads. At the load-to-failure test, Group KA exhibited significantly lower displacements at representative subcritical loads and higher resistance to development of clinically relevant displacements. The authors conclude that use of a knotless suture anchor attached at the distal outlet of the bone tunnel may be an effective solution to reduce root displacements in transtibial meniscal root repairs, a matter reported to alter biomechanics of joint contact.
半月板根部完整性对于维持膝关节接触负荷分布和稳定性非常重要。经骨缝合技术通常用于修复半月板根部撕裂。然而，临床效果并不完全令人满意。特别是对于修复后根部的明显移位存在担忧。本研究旨在评估在胫骨隧道远端出口处使用带线锚钉固定缝线是否优于在皮质纽扣上打结缝线，从而提高经胫骨修复的即刻生物力学性能。20 个具有分离后内侧半月板根部的猪胫骨随机分为两组，根据根部修复后固定缝线的方法：带线锚钉（KA）或缝线纽扣（SB）。标本进行了循环和失效负荷测试。KA 组在低水平重复负荷后残余根部移位明显较小。在失效负荷测试中，KA 组在代表亚临界负荷时的位移明显较低，并且对发展具有临床相关性的位移具有更高的抵抗力。作者得出结论，在骨隧道的远端出口处使用无结缝线锚钉可能是减少经胫骨半月板根部修复中根部移位的有效方法，据报道，这会改变关节接触的生物力学。
