A novel meniscal root refixation pull-in technique with an all-suture anchor shows biomechanicalproperties comparable to standard suture anchor and transtibial pull-out techniques.

Briese T, Kieninger A, Peez C, Deichsel A, Herbst E, Balke M, Raschke MJ, Kittl C

Abstract

PurposeRepair techniques for posterior meniscal root (PMMR) tears include repair with transtibial pull-out and anchors. An alternative approach uses all-suture anchors pulled in, avoiding a posterior medial portal. While clinical feasibility has been assessed, biomechanical properties of this technique remain unknown. We hypothesised that the biomechanical properties using the pull-in technique would be comparable to those achieved with conventional repair techniques.MethodsFifty fresh-frozen porcine tibiae were fixed in a steel pot. Whereas in group (1) the native meniscal root was kept intact (native meniscal root (NM)), the PMMR was sectioned and refixed in groups (2)-(5): (2) Double-loaded suture anchor (screw anchor) (SA), (3) transtibial pull-out repair with two sutures (TTPO), (4) double-loaded pull-in repair with all-suture anchor that was pulled into the subcortical bone which was predrilled from retrograde direction (PULL) and (5) double-loaded push-in repair with all-suture anchor traditionally pushed into the predrilled subcortical bone in antegrade direction (PUSH). Testing was performed using a universal testing machine with 1000 cycles (5-20 N/0.5 Hz) with subsequent load-to-failure (LTF) meaning failure of the NM or refixation. Outcomes measured included LTF (N), cyclic displacement (mm), and stiffness (N/mm). The failure mode was documented macroscopically.Study designControlled laboratory study.ResultsNo repair technique restored the stability of the NM, reaching 1064.6 +/- 226.0 N in LTF (p