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I just saw my orthopedic surgeon for a pre-op appointment. I'm having a meniscal repair done next week. He mentioned a certain type of suturing technique that will give me good fixation. Can you explain this a little more to me?

For quite some time now, orthopedic surgeons have known that repairing a torn meniscus has a better result than taking it out. Removing this cartilage in the knee can lead to faster wear and tear and osteoarthritis in the end.

There are many ways to do these repairs. The surgeon may use an open incision but it's more likely you'll have arthroscopic surgery instead. The arthroscope is a long thin needle that is inserted into the joint. There's a tiny TV camera on the end to give the surgeon a visual image on a TV screen.

Arthroscopic repairs can be done all from inside, from inside-out, and from outside-in. The repair technique depends on the type, size, and location of the tear. Whatever method is used, the goal is to get a good, strong repair that won't tear. The strength of the repair is called the fixation strength.

Fixation strength has been tested on cadaver (donor) menisci. A special machine is used to test the ultimate tension load (UTL). This is the amount of force it takes to tear a meniscus or tear the suture holding a torn meniscus in place.

Researchers are testing a new method of suturing the meniscus called the cruciate suture. Early results show a 1.6 greater strength of this method over the more standard approach using a vertical suture for long or complex tears. The type of repair and fixation strength you'll have will depend on the method your surgeon uses for you.

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