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The American Journal of Sports Medicine 27:626-631 (1999)
© 1999 American Orthopaedic Society for Sports Medicine

Pull-Out Strength and Stiffness of Meniscal Repair Using Absorbable Arrows or Ti-Cron Vertical and Horizontal Loop Sutures

Uli W. Boenisch, MD{dagger},{ddagger}, Kenneth J. Faber, MD{dagger}, Michael Ciarelli, PhD§, J. Richard Steadman, MD{dagger} and Steven P. Arnoczky, DVM§

{dagger} Steadman Hawkins Sport Medicine Foundation, Vail, Colorado
§ Laboratory for Comparative Orthopaedic Research, Michigan State University, College of Veterinary Medicine, East Lansing, Michigan

Presented at the 8th Congress of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA), Nice, France, April 1998.

{ddagger} Address correspondence and reprint requests to Uli W. Boenisch, MD, Von Osten Strasse 11, 86199 Augsburg, Germany

We tested pull-out strength and linear stiffness of meniscal repair using bioabsorbable arrows and vertical and horizontal loop sutures in fresh-frozen bovine lateral menisci. In phase I, menisci repaired either with 2–0 Ti-Cron vertical or horizontal loop suture, or 10-, 13-, or 16-mm Meniscus Arrows were loaded to failure at 12.5 mm/sec. In phase II, we examined the number of barbs engaged and angle of insertion using 10- and 13-mm arrows. Pull-out strengths of both suture repair groups were significantly higher than those of the arrow groups. Vertical loop sutures were significantly stiffer than horizontal sutures and 10-mm arrows. In phase II, the mean ultimate load to failure for the 10-mm arrows was 35.1 N, significantly stronger than in phase I (18.5 N); however, stiffness remained low (7.9 N/mm). Five arrows in the 13-mm group were inserted parallel to the tibial surface and showed no significant difference from phase I. Five arrows were inserted at more than a 30° angle. This group was significantly weaker than in phase I. Single vertical loop suture showed the highest overall pull-out strength. Although weaker than sutures, arrows should provide sufficient stability for meniscal healing. The number of barbs engaged and angle of insertion are critical.




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