Petillo Antonio, Di Rosa Alessandro, Burgio Carmelo, Di Leonardo Sofia, Burriesci Gaetano, Bosco Francesco, Lucenti Ludovico, Camarda Lawrence
Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.) University of Palermo Palermo Italy.
Adult Reconstruction and Joint Replacement Service Hospital for Special Surgery New York New York USA.
J Exp Orthop. 2025 Jul 18;12(3):e70366. doi: 10.1002/jeo2.70366. eCollection 2025 Jul.
Radial meniscal tears significantly impact knee biomechanics and can lead to joint degeneration if untreated. While various suture techniques exist, no consensus has been reached on the optimal method. The hypothesis was that the double-loop suture can significantly reduce displacement between tear segments and achieve a higher ultimate failure load than conventional techniques. This study aims to biomechanically compare conventional repair techniques to a novel double-loop suture to enhance tensile strength, reduce displacement and improve meniscal repair outcomes.
Forty fresh-frozen porcine menisci with full-thickness radial tears were repaired using four techniques: double vertical, double horizontal, cross-tie and double-loop sutures. Biomechanical testing included cyclic loading (200 cycles, 5-19 N) and ultimate failure load evaluation. Key outcomes measured were displacement after cyclic loading, failure load, and failure modes. A one-way analysis of variance (ANOVA) was conducted to identify significant differences among groups.
Among the evaluated techniques, the double-loop suture demonstrated the highest ultimate failure load (111.1 ± 17.3 N, < 0.01). Displacement after cyclic loading was minimal across techniques, except for the double vertical suture, which showed significantly higher displacement. Knot breakage was the primary failure mode in conventional sutures, whereas the double-loop suture also exhibited tissue cutting.
The double-loop suture provides superior biomechanical performance, offering greater tensile strength and stability than conventional methods. Its simplicity and arthroscopic applicability highlight its potential for advanced meniscal repair. The double-loop suture could be applied in the arthroscopic setting, improving the outcomes for treating radial tears. Further clinical studies are needed to confirm long-term efficacy.
Level IV, cadaveric study.
外侧半月板撕裂会显著影响膝关节生物力学，若不治疗可导致关节退变。虽然存在多种缝合技术，但对于最佳方法尚未达成共识。假设双环缝合法能显著减少撕裂部位之间的位移，并比传统技术实现更高的极限破坏载荷。本研究旨在对传统修复技术与新型双环缝合法进行生物力学比较，以提高拉伸强度、减少位移并改善半月板修复效果。
采用四种技术修复40个具有全层外侧撕裂的新鲜冷冻猪半月板：双垂直缝合法、双水平缝合法、交叉缝合法和双环缝合法。生物力学测试包括循环加载（200次循环，5 - 19 N）和极限破坏载荷评估。测量的关键结果包括循环加载后的位移、破坏载荷和破坏模式。进行单因素方差分析（ANOVA）以确定组间的显著差异。
在评估的技术中，双环缝合法显示出最高的极限破坏载荷（111.1 ± 17.3 N，< 0.01）。除双垂直缝合法显示出明显更高的位移外，各技术在循环加载后的位移均最小。结断裂是传统缝合的主要破坏模式，而双环缝合法还表现出组织切割。
双环缝合法具有卓越的生物力学性能，比传统方法提供更大的拉伸强度和稳定性。其简单性和关节镜适用性突出了其在高级半月板修复中的潜力。双环缝合法可应用于关节镜手术，改善外侧撕裂的治疗效果。需要进一步的临床研究来证实其长期疗效。
IV级，尸体研究。
