Original Article

Biomechanical comparison of the tensile strength of fixation implants used for pull-out repair of medial meniscus posterior root tear

¹ Department of Orthopedic Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan
² Department of Orthopedic Surgery, Ishibashi General Hospital, 1-15-4 Shimokoyama, Shimotsuke, 329-0596, Japan

^* Corresponding author: tsuneari9@jichi.ac.jp

Received: 19 March 2024
Accepted: 2 August 2024

Abstract

Purpose: Medial meniscus posterior root tears (MMPRT) pull-out repair aims to restore the meniscus’ anatomical structure. Different implants are utilized for thread fixation in the pull-out repair technique for MMPRT. However, biomechanical evidence comparing the fixation strengths of these implants remains unavailable. This study investigated the tensile strength of three fixation implants in porcine knee models of MMPRT pull-out repair. Methods: This study categorized 30 porcine MMPRT models undergoing pull-out repair into three groups (10 specimens each) based on the implant utilized for fixation, including double spike plate, metallic interference screw (IFS), and resorbable IFS fixed group. A tensile tester was used to track the suture wire threaded to the medial meniscus anterior root. The displacement length was recorded after 10 and 20 loading cycles (10–30 N, 100 mm/min cross-head speed). Each specimen was then stretched to failure (50 mm/min cross-head speed), failure modes were recorded, and structural properties (maximum load, linear stiffness, elongation at failure, and elongation at yield) were compared. Fisher’s exact test and one-way analysis of variance were utilized to assess the differences. Results: No significant differences in displacement length, upper yield load, maximum load, linear stiffness, elongation at yield, elongation at failure, and frequency of failure mode were observed between the three groups. Conclusion: All implants were comparable in terms of fixation strength. Thus, resorbable interference screws may be particularly useful in this technique and does not require implant removal surgery. Level of evidence: IV.