Takahashi Tsuneari, Takeshita Katsushi
Department of Orthopaedic Surgery, Ishibashi General Hospital, Shimotsuke, JPN.
Department of Orthopaedics, Jichi Medical University, Shimotsuke, JPN.
Cureus. 2023 Jul 24;15(7):e42378. doi: 10.7759/cureus.42378. eCollection 2023 Jul.
Background Medial meniscal posterior root tear has garnered attention because it causes increased joint contact pressure and loss of load distribution function. Currently, the common treatment for posterior meniscal root tears is transtibial pullout repair, and loop suture remains the gold standard procedure. Purpose The aim of this study is to validate whether the meniscus-suture complex exhibits better structural properties after loop stitch using a suture tape versus the conventional thread. Study design and methods This is a controlled laboratory study. In total, 20 menisci harvested from castrated male pigs were prepared and randomly assigned to two suturing techniques: loop stitch using ULTRATAPE (n = 10, tape group) or loop stitch using 2-0 UltraBraid (n = 10, control group). The single-loop stitch meniscus-suture technique was used. A single suture using ULTRATAPE or 2-0 UltraBraid was placed through the meniscus 5 mm medial from the resected edge of the posterior meniscus horn. The meniscus-suture complex specimens were mounted on a tensile tester to apply tensile load on the meniscus-suture complex parallel to the long axis of the stitched suture materials. Each specimen was stretched to failure at a crosshead speed of 50 mm/minute. The structural properties of the meniscus-suture complex (maximum load, linear stiffness, and elongation at failure) were determined. Results In the tape group, all the repaired complexes were torn at the ligature; conversely, in the control group, the threads were torn in three of 10 specimens, and the repaired complexes in the remaining seven specimens were torn at the ligature. No significant between-group differences were observed in linear stiffness (9.0 ± 4.1 vs 7.1 ± 2.9 N/mm) and elongation at failure (15.8 ± 6.1 vs 19.6 ± 20.1 mm); however, the tape group exhibited a significantly higher average maximum load than the control group (104.6 ± 41.2 vs 62.6 ± 32.1 N; = 0.020). Conclusion Suture tape can be a potential alternative to the conventional thread for Medial meniscal posterior root tear repair. Clinical relevance Medial meniscal posterior root tear repair using tape rather than the conventional thread may be beneficial in obtaining better structural properties.
背景 内侧半月板后根撕裂因其会导致关节接触压力增加和负荷分布功能丧失而受到关注。目前,半月板后根撕裂的常见治疗方法是经胫骨拉出修复,而袢式缝合仍然是金标准手术。目的 本研究的目的是验证使用缝线带进行袢式缝合后,半月板 - 缝线复合体是否比传统缝线表现出更好的结构性能。研究设计与方法 这是一项对照实验室研究。总共从去势雄性猪身上获取20个半月板,并随机分配到两种缝合技术:使用ULTRATAPE进行袢式缝合(n = 10,胶带组)或使用2-0 UltraBraid进行袢式缝合(n = 10,对照组)。采用单袢式缝合半月板 - 缝线技术。使用ULTRATAPE或2-0 UltraBraid单根缝线从后半月板角切除边缘内侧5mm处穿过半月板。将半月板 - 缝线复合体标本安装在拉伸试验机上,沿缝合缝线材料的长轴方向对半月板 - 缝线复合体施加拉伸载荷。每个标本以50mm/分钟的十字头速度拉伸至破坏。测定半月板 - 缝线复合体的结构性能(最大载荷、线性刚度和破坏伸长率)。结果 在胶带组中,所有修复的复合体均在结扎处撕裂;相反,在对照组中,10个标本中有3个的缝线撕裂,其余7个标本中的修复复合体在结扎处撕裂。线性刚度(9.0±4.1 vs 7.1±2.9N/mm)和破坏伸长率(15.8±6.1 vs 19.6±20.1mm)在组间未观察到显著差异;然而,胶带组的平均最大载荷显著高于对照组(104.6±41.2 vs 62.6±32.1N;P = 0.020)。结论 对于内侧半月板后根撕裂修复,缝线带可能是传统缝线的一种潜在替代物。临床意义 使用胶带而非传统缝线进行内侧半月板后根撕裂修复可能有助于获得更好的结构性能。