Massey Patrick A, Dudoussat Edwin, Montgomery Carver, Scalisi Wayne, McBride Hayden, Rutz Robert, Solitro Giovanni F
Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA.
Cartilage. 2024 Sep 29:19476035241284827. doi: 10.1177/19476035241284827.
The purpose of the study was to determine average tensile forces resulting in suture failure while tying a knot during repair of complete radial meniscus tears and to compare the failure tensile force based on meniscus tissue location: the peripheral (red-red) versus inner (white-white).
This study was designed as a cadaveric biomechanical study using 24 menisci harvested from fresh frozen cadaveric knees with midbody radial tears. Tears were repaired using 2-0 nonabsorbable suture in both the inner meniscus and the peripheral meniscus. A force gauge was used to measure the tension of a surgeon's knot until failure of either the suture or the meniscus tissue. Statistical analysis was performed comparing suture failure tensile forces between inner and peripheral sutures using 2-sample test.
Suture repairs primarily failed due to meniscal tissue cut-out after suture tensioning (96%). There was no statistical difference in failure mode between medial and lateral meniscus for both the inner (100% cut-out) and the peripheral (92% cut-out; = 0.703) sutures. The peripheral sutures failed as significantly higher loads (54 ± 26 N) than the inner sutures (36 ± 11 N, = 0.006). The peripheral meniscus tissue tolerated significantly higher tension at failure (36 ± 7 N) than the inner meniscus (26 ± 7 N, < 0.001).
When tying parallel sutures to repair a radial meniscus tear, suture tensile forces above 30 N may tear through meniscus tissue. Surgeons should not use suture tying forces above 30 N when repairing radial meniscus tears with parallel sutures. The peripheral meniscus can withstand higher knot-tying forces than the inner meniscus, so surgeons should consider tying the peripheral suture before the inner suture.
本研究的目的是确定在完全性桡侧半月板撕裂修复过程中打结时导致缝线断裂的平均拉力，并根据半月板组织位置（外周[红-红]与内侧[白-白]）比较断裂拉力。
本研究设计为尸体生物力学研究，使用从新鲜冷冻尸体膝关节获取的24个有体中部桡侧撕裂的半月板。在内侧半月板和外周半月板均使用2-0不可吸收缝线修复撕裂。使用测力计测量外科结的张力，直至缝线或半月板组织断裂。采用双样本检验对内侧和外周缝线的缝线断裂拉力进行统计分析。
缝线修复主要因缝线张紧后半月板组织穿出而失败（96%）。内侧和外侧半月板的内侧（100%穿出）和外周（92%穿出；P = 0.703）缝线在失败模式上无统计学差异。外周缝线的断裂负荷（54±26 N）显著高于内侧缝线（36±11 N，P = 0.006）。外周半月板组织在断裂时耐受的张力（36±7 N）显著高于内侧半月板（26±7 N，P < 0.001）。
在使用平行缝线修复桡侧半月板撕裂时，缝线拉力超过30 N可能会撕裂半月板组织。外科医生在用平行缝线修复桡侧半月板撕裂时，不应使用超过30 N的缝线打结力。外周半月板比内侧半月板能承受更高的打结力，因此外科医生应考虑先打外周缝线，再打内侧缝线。
