Barber F Alan, Davidson Philip A, Henninger Heath B
Plano Orthopedic and Sports Medicine Center, Plano, Texas, USA.
Davidson Orthopedics, Salt Lake City, Utah, USA.
Orthop J Sports Med. 2024 May 24;12(5):23259671241245127. doi: 10.1177/23259671241245127. eCollection 2024 May.
Recently, all-suture, all-inside meniscal repair devices-including devices containing flat sutures or tapes-have been introduced. Similar to those in suture anchors, these modifications may have different performance characteristics than conventional sutures and polyether ether ketone (PEEK)-anchored devices.
To compare the biomechanical characteristics of all-suture meniscal repair devices with those of a conventional PEEK-anchored device and an inside-out meniscal suture construct.
Controlled laboratory study.
A total of 48 adult porcine menisci with simulated bucket-handle tears were included. Single-device repairs were performed with the SuperBall Meniscal Repair System, FiberStitch, and FAST-FIX 360 with 2 PEEK anchors, and a vertical mattress inside-out suture repair was performed using a Ti-Cron No. 2-0 braided polyethylene terephthalate suture. All specimens were preloaded (10 N) and cycled 200 times (between 10 and 50 N). Specimens surviving cyclic loading were then destructively tested. Endpoints included maximum failure load, stiffness, cyclic displacement, and failure mode. The goal was 12 successful tests in each group. Metrics between groups were compared using analysis of variance with post hoc tests to control for multiple comparisons.
The SuperBall (108.9 N) was significantly stronger than the FAST-FIX 360 (67.3 N) and Ti-Cron (75.2 N), and the FiberStitch (102.8 N) was significantly stronger than the FAST-FIX 360 (≤ .01 for all). Cyclic stiffness increased during cyclic loading for all constructs ( < .001). The Ti-Cron was significantly stiffer than the SuperBall during 5 to 200 cycles ( < .001). Cyclic displacement significantly increased in all constructs during cycling ( < .001) but did not differ between devices. Failure mode varied by device: the Ti-Cron repairs failed because of suture breakage, the SuperBall and FAST-FIX 360 failed at the anchor, and the FiberStitch showed both failure modes.
The all-suture, all-inside meniscal repair devices demonstrated superior strength to the PEEK-anchored device and the classic inside-out suture meniscal repair but no statistically significant difference in cyclic displacement.
最近，全缝合、全内置半月板修复装置——包括含有扁平缝线或带的装置——已被引入。与缝合锚钉中的装置类似，这些改良装置可能具有与传统缝线和聚醚醚酮（PEEK）锚定装置不同的性能特征。
比较全缝合半月板修复装置与传统PEEK锚定装置及由外向内半月板缝合结构的生物力学特性。
对照实验室研究。
共纳入48个模拟桶柄状撕裂的成年猪半月板。使用SuperBall半月板修复系统、FiberStitch、带2个PEEK锚钉的FAST-FIX 360进行单装置修复，并用2-0号Ti-Cron编织聚对苯二甲酸乙二酯缝线进行垂直褥式由外向内缝合修复。所有标本均预先加载（10 N）并循环加载200次（10至50 N之间）。对在循环加载后存活的标本进行破坏性测试。终点指标包括最大破坏载荷、刚度、循环位移和破坏模式。目标是每组成功测试12次。使用方差分析及事后检验比较组间指标以控制多重比较。
SuperBall（108.9 N）显著强于FAST-FIX 360（67.3 N）和Ti-Cron（75.2 N），FiberStitch（102.8 N）显著强于FAST-FIX 360（所有比较P≤0.01）。所有结构在循环加载过程中循环刚度均增加（P<0.001）。在5至200次循环中，Ti-Cron的刚度显著高于SuperBall（P<0.001）。所有结构在循环过程中循环位移均显著增加（P<0.001），但各装置之间无差异。破坏模式因装置而异：Ti-Cron修复因缝线断裂而失败，SuperBall和FAST-FIX 360在锚钉处失败，FiberStitch显示出两种失败模式。
全缝合、全内置半月板修复装置显示出比PEEK锚定装置和经典的由外向内缝合半月板修复更强的强度，但在循环位移方面无统计学显著差异。
