AUGMENTATION OF MENISCAL REPAIRS WITH CYANOACRYLATE GLUE

Cyanoacrylate glues are biodegradable, bacteriostatic, hemostatic adhe sives which have been used experimentally in surgical procedures on ma ny tissues. This study evaluates the efficacy of cyanoacrylate glues u sed for in vitro bovine meniscus repair. Our hypothesis was that a loc al adhesive might improve fixation of meniscus fears reapproximated wi th suture, or obviate the need for suture. Three high-viscosity flexib le cyanoacrylate glues were tested and their tensile strengths compare d to those of suture alone and suture augmented with glue. The flexibl e formulation enables the glue to deform with the meniscus during move ment of the knee joint. Bovine meniscus tissue was used as the model t o compare the tensile strength at the meniscus repair site using the 3 00 cps glue in combination with 3-0 prolene suture, 300 cps cyanoacryl ate glue alone, and suture alone. Twenty specimens were included in ea ch repair group, and the peak load to failure was normalized for surfa ce area and subjected to analysis of variance. Results of the analysis showed that the peak load to failure of the combination of cyanoacryl ate glue plus suture was significantly higher than that of glue alone (P < .0001), but not significantly higher than that of suture alone (P = .18). However, in tissues repaired with suture, tissue separation a t the tear site was noted almost immediately after distraction started , as a result of the elasticity of the suture. The combination of cyan oacrylate glue plus suture provided the maximum tensile strength befor e tissue separation. Because tissue separation may interfere with the meniscal healing process, glue used in combination with suture appears to offer some advantage mechanically. The cyanoacrylate formulations studied did not seem suitable for use without suture in meniscus repai r. (C) 1995 John Wiley & sons, Inc.