LOAD TO FAILURE OF COMMON MENISCAL REPAIR TECHNIQUES - EFFECTS OF SUTURE TECHNIQUE AND SUTURE MATERIAL

Success of meniscal repair with early or immediate motion depends on t he ability of the suture fixation to withstand the loads applied. Vert ical and horizontal mattress suture techniques were tested using 2-0 E thibond, and 0-PDS and 1-PDS sutures (Ethicon, Somerville, NJ). Mulber ry knot technique was tested with 0-PDS and 1-PDS sutures. Twenty meni sci (60 sutures) were tested for each suture material. Sutures were pl aced 3 to 4 mm from the peripheral edge of the meniscus with double ba rreled cannulas for vertical and horizontal mattress techniques or a s pinal needle for the mulberry knot technique, reproducing clinical tec hniques of meniscal repair. Mechanical testing of suture fixation was performed to failure at a rate of 10 mm/min on a MTS material testing system (MTS Systems Corp, Minneapolis, MN), Suture pullouts were repor ted as the load displacement to failure from the inner fragment only, because clinical failure would ensue should a suture pull through the inner fragment of a tear. Vertical mattress technique with 1-PDS sutur e had significantly greater load to failure than any other combination (P < .05). Analysis of variance showed that the vertical mattress tec hnique had statistically superior pullout strength (P < .0001) compare d with the horizontal mattress and mulberry knot techniques, which wer e statistically similar, There were significant differences (P < .0001 ) between suture types, with 1-PDS proving best compared with 0-PDS, w hich was stronger than 2-0 Ethibond. Selection of suture material had the greatest impact on vertical mattress load to failure and was not i mportant to the strength of the other techniques.