Cinque Mark E, Hinz Maximillian, Sidrak Jason, Hollenbeck Justin F M, Buchalter Wyatt H, Kanakamedala Ajay, Mitchell Justin J, Godin Jonathan A, Provencher Matthew T
Steadman Philippon Research Institute, Vail, Colorado, USA.
The Steadman Clinic, Vail, Colorado, USA.
Am J Sports Med. 2025 Jul;53(9):2128-2135. doi: 10.1177/03635465251342267. Epub 2025 Jul 16.
Posterior medial meniscus root tears are commonly treated with a transtibial pull-out (TO) repair, but significant postoperative meniscal extrusion has been reported. Recently, knotless adjustable suture anchor fixation has been introduced to treat root tears. This anchor-based fixation demonstrates less cyclic displacement than a TO repair. However, it is unknown how meniscal extrusion and contact mechanics compare between these 2 repair techniques when the meniscus endures cyclic tibiofemoral loading.
Suture anchor repair will demonstrate reduced meniscal extrusion and lower medial compartment pressure at the 1000th cycle compared with the TO repair.
Controlled laboratory study.
Eight pairs of cadaveric knees were used to compare extrusion and contact pressure between transtibial fixation and suture anchor repair techniques for medial meniscus posterior root tears. Each specimen underwent cyclic compressive loading (0th, 100th, 500th, and 1000th cycles). Medial meniscal extrusion was assessed with the knee at full extension using ultrasound, and medial compartment contact pressures were evaluated using pressure sensors. Statistical analyses included paired tests and repeated-measures analysis of variance with an alpha level set at .05.
The suture anchor repair technique demonstrated significantly lower absolute and relative medial meniscal extrusion compared with transtibial fixation repair after 500 and 1000 cycles of loading ( = .012 and = .001, respectively). Similarly, mean medial compartment pressures were significantly lower in the suture anchor repair group compared with the transtibial fixation repair group after 1000 cycles ( = .028). No significant differences were found in peak pressures between the 2 repair techniques.
The suture anchor repair demonstrated lower medial meniscal extrusion and reduced medial compartment contact pressures after time-zero cyclic loading. This biomechanical profile may be important for increasing the likelihood of healing and may translate to improved long-term outcomes for patients undergoing meniscus root repair.
Understanding the biomechanical differences between repair techniques at time zero may be crucial for optimizing surgical outcomes and minimizing the risk of long-term joint degeneration after meniscus root tears. Future clinical studies should further investigate these findings in live patient populations to validate their effect on root healing, functional outcomes, and long-term osteoarthritis progression.
后内侧半月板根部撕裂通常采用经胫骨拉出式（TO）修复治疗，但有报道称术后半月板显著挤出。最近，无结可调缝线锚钉固定已被引入用于治疗根部撕裂。这种基于锚钉的固定方式在循环位移方面比TO修复更少。然而，当半月板承受胫股循环负荷时，这两种修复技术在半月板挤出和接触力学方面如何比较尚不清楚。
与TO修复相比，缝线锚钉修复在第1000个循环时将显示出半月板挤出减少和内侧间室压力降低。
对照实验室研究。
使用八对尸体膝关节比较经胫骨固定和缝线锚钉修复技术治疗内侧半月板后根部撕裂的挤出和接触压力。每个标本接受循环压缩负荷（第0、100、500和1000个循环）。在膝关节完全伸展时使用超声评估内侧半月板挤出，并使用压力传感器评估内侧间室接触压力。统计分析包括配对t检验和重复测量方差分析，α水平设定为0.05。
在500和1000个循环负荷后，与经胫骨固定修复相比，缝线锚钉修复技术显示出绝对和相对内侧半月板挤出显著更低（分别为P = 0.012和P = 0.001）。同样，在1000个循环后，缝线锚钉修复组的平均内侧间室压力与经胫骨固定修复组相比显著更低（P = 0.028）。两种修复技术之间的峰值压力没有发现显著差异。
缝线锚钉修复在零时循环负荷后显示出更低的内侧半月板挤出和降低的内侧间室接触压力。这种生物力学特征对于增加愈合可能性可能很重要，并且可能转化为半月板根部修复患者更好的长期结果。
了解零时修复技术之间的生物力学差异对于优化手术结果和最小化半月板根部撕裂后长期关节退变风险可能至关重要。未来的临床研究应在活体患者群体中进一步研究这些发现，以验证它们对根部愈合、功能结果和长期骨关节炎进展的影响。
