Biomechanical evaluation of different suture materials for arthroscopic transtibial pull-out repair of posterior meniscus root tears

Purpose: To evaluate the biomechanical properties of four different suture materials for arthroscopic transtibial pull-out repair of posterior meniscus root tears, with special focus on the meniscus–suture interface.

Methods: Forty fresh-frozen lateral porcine menisci were used. The posterior meniscus root was sutured in a standardized fashion with a simple stitch using four different suture materials: group A, No. 2 PDS™; group B, No. 2 Ethibond™; group C, No. 2 FiberWire™; and group D, 2-mm Fibertape™. Meniscus–suture constructs were subjected to cyclic loading followed by load-to-failure testing using a servo-hydraulic material testing machine.

Results: During cyclic loading, group D showed a significantly higher displacement after 100, 500, and 1,000 cycles compared to group A (p < 0.001, p = 0.001, and p = 0.001), and a significantly higher displacement after 100 and 500 cycles compared to group B (p = 0.010 and p = 0.045). Group C showed a significantly higher displacement compared to group A after 100 cycles (p = 0.008). The highest maximum load was observed in group D, with significant differences compared to group A (p = 0.013). Group B showed a significantly higher stiffness compared to group A (p = 0.023), and both group C and group D showed a significantly higher stiffness compared to group A and group B (p < 0.001).

Conclusion: None of the evaluated suture materials provided clearly superior properties over the others during both cyclic loading and load-to-failure testing. Based on the results of this study, FiberWire™ may be the preferred suture material for transtibial pull-out repair of posterior meniscus root tears because of comparably low displacement during cyclic loading and high values for maximum load and stiffness. In the clinical setting, FiberWire™ may improve healing rates and avoid progressive extrusion of the meniscus after transtibial pull-out repair of posterior meniscus root tears.