Double-loop suture repair of radial meniscal tears provides favourable biomechanical performance compared to conventional repair techniques: A biomechanical study.

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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 OF EVIDENCE

Level IV, cadaveric study.