Initial fixation strength of flexible all-inside meniscus suture anchors in comparison to conventional suture technique and rigid anchors: biomechanical evaluation of new meniscus refixation systems.

BACKGROUND The newest generation of meniscus repair devices is designed to combine the benefits of the all-inside technique with the biomechanical properties of sutures. HYPOTHESIS New flexible all-inside suture anchors have better fixation strength than rigid anchors, but there is no difference when compared to conventional horizontal and vertical mattress sutures. STUDY DESIGN Controlled laboratory study. METHODS In fresh-frozen bovine menisci, initial fixation strength, stiffness, and failure mode of different meniscus fixation techniques (FastT-Fix, RapidLoc, Meniscus Arrow, horizontal and vertical 2.0 Ethibond sutures) were evaluated in a computer-based materials testing machine at a rate of 12.5 mm/sec. RESULTS The vertical and horizontal FastT-Fix suture anchors were the strongest devices with regard to pullout strength, with no significant difference compared to the vertical 2-0 Ethibond sutures. Horizontal sutures, Meniscus Arrow, and RapidLoc had significantly lower pullout strength. Vertical and horizontal FastT-Fix suture anchors showed significantly higher stiffness than the other devices. CONCLUSIONS Biomechanical properties of flexible all-inside meniscus anchors (FastT-Fix) are comparable to conventional vertical suture techniques. Characteristics of the flexible RapidLoc are comparable to rigid anchors (Meniscus Arrow). CLINICAL RELEVANCE From the biomechanical point of view, flexible all-inside meniscus refixation devices are an alternative to conventional suture techniques and rigid meniscus anchors.