All-inside meniscal repair devices compared with their matched inside-out Vertical mattress suture repair. Introducing 10,000 and 100,000 loading cycles
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Author (Corporation)
Publication date
01.09.2014
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Type
01A - Journal article
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Parent work
The American Journal of Sports Medicine
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DOI of the original publication
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Series
Series number
Volume
42
Issue / Number
9
Pages / Duration
2226 - 2233
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Publisher / Publishing institution
SAGE
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Practice partner / Client
Abstract
All-inside arthroscopic meniscal repairs are favored by most clinicians because of their lower complication rate and decreased morbidity compared with inside-out techniques. Until now, only 1000 cycles have been used for biomechanical testing. Hypothesis: All-inside meniscal repairs will show inferior biomechanical response to cyclic loading (up to 100,000 cycles) and load-to-failure testing compared with inside-out suture controls. Study Design: Controlled laboratory study. Methods: Bucket-handle tears in 72 porcine menisci were repaired using the Omnispan and Fast-Fix 360 (all-inside devices) and Orthocord 2-0 and Ultrabraid 2-0 sutures (matched controls). Initial displacement, displacement after cyclic loading (100, 500, 1000, 2000, 5000, 10,000, and 100,000 cycles) between 5 and 20 N, ultimate load to failure, and mode of failure were recorded, as well as stiffness. Results: Initial displacement and displacement after cyclic loading were not different between the groups. The Omnispan repair demonstrated the highest load-to-failure force (mean 6 SD, 151.3 6 21.5 N) and was significantly stronger than all the other constructs (Orthocord 2-0, 105.5 6 20.4 N; Ultrabraid 2-0, 93.4 6 22.5 N; Fast-Fix 360, 76.6 6 14.2 N) (P \ .0001 for all). The Orthocord vertical inside-out mattress repair was significantly stronger than the Fast-Fix 360 repair (P = .003). The Omnispan (30.8 6 3.5 N/mm) showed significantly higher stiffness compared with the Ultrabraid 2-0 (22.9 6 6.9 N/mm, P \ .0001) and Fast-Fix 360 (23.7 6 3.9 N/mm, P = .001). The predominant mode of failure was suture failure. Conclusion: All-inside meniscal devices show comparable biomechanical properties compared with inside-out suture repair in cyclic loading, even after 100,000 cycles. Clinical Relevance: Eight to 10 weeks of rehabilitation might not pose a problem for all repairs in this worst-case scenario.
Keywords
All-inside, Biomechanical testing, Biomechanics, Fast-Fix 360, Meniscus, Omnispan, Orthocord, Repair, Ultrabraid
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ISBN
ISSN
0363-5465
1552-3365
1552-3365
Language
English
Created during FHNW affiliation
Yes
Strategic action fields FHNW
Publication status
Published
Review
Peer review of the complete publication
Open access category
Closed
License
Citation
Rosso, C., Müller, S., Buckland, D. M., Schwenk, T., Zimmermann, S., de Wild, M., & Valderrabano, V. (2014). All-inside meniscal repair devices compared with their matched inside-out Vertical mattress suture repair. Introducing 10,000 and 100,000 loading cycles. The American Journal of Sports Medicine, 42(9), 2226–2233. https://doi.org/10.1177/0363546514538394