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A New Repair Suture for Arthroscopic Meniscal Repair
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Posted on: 10/12/2006
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This is the first report of a new suturing method for meniscal tears. The new technique called the cruciate suture is described in detail. The new method provides high fixation strength, which is needed for meniscal tears.
The cruciate suture is recommended for the repair of long tears, complex tears, and degenerative tears. It is especially good for the treatment of elderly patients with meniscal tears.
Surgeons use a variety of methods to repair the torn meniscus. There are four main methods based on whether an open incision is used versus arthroscopic surgery. If arthroscopy is used, then methods are described based on how the needle is inserted. The four main methods of meniscal repair include: 1) open, 2) arthroscopic inside-out, 3) arthroscopic outside-in, and 4) arthroscopic all-inside. The cruciate suture is an arthroscopic outside-in technique.
The cruciate suture was tested on human menisci donated from patients who had a total knee replacement. All donor menisci were from patients with an average age of 75 years. The cartilage was in good condition with no obvious signs of degeneration.
A special testing machine was used to test the ultimate tension load (ULT) of each menisci. The UTL is the maximum load applied to the cartilage before it tears. Once testing was completed, the cruciate suture was made in each meniscus. The strength of the suture was tested using the UTL as the measure. The results were compared with the UTL for repair using a vertical suture.
The authors report greater fixation strength with the new cruciate suture. The UTL for a vertical suture was 67 N compared to 110 N for the cruciate suture. The cruciate suture was 1.6 times stronger than the vertical method, which is currently the gold standard for long, complex, or degenerative meniscal repairs.
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References:
Ashraf Abdelkafy, MSc, et al. The "Cruciate Suture" for Arthroscopic Meniscal Repair: A New Technique. In The Journal of Arthroscopic and Related Surgery. October 2006. Vol. 22. No. 10. Pp. 1134.e1-1134.e5.
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