Biomechanical Comparison of Suture Techniques in Radial Meniscal Tears Using Gap Configuration Analysis.

Vertical, horizontal, and cross sutures have not been compared simultaneously in double suture fashion for the repair of radial meniscal tears. This study compared suture strength among these 3 techniques using gap configuration analysis. Biomechanical testing was performed on 60 matched and paired porcine menisci that were repaired with 2 stitches of vertical, horizontal, and cross sutures. The specimens were cyclically loaded 500 times at 5 to 30 N, and central, peripheral, and total gap distance were measured. After completing cyclic load testing, the specimens were loaded to failure. Double vertical sutures demonstrated significantly lower total and central gap displacement than cross and double horizontal sutures (P<.05). However, there was no significant difference in peripheral gap formation within each group (P=.53). Ultimate failure load and stiffness were significantly greater for double vertical sutures (146.3 N) than for cross (113.8 N) and double horizontal sutures (107.2 N) (P<.05). Stiffness also was significantly increased for double vertical sutures (14.6 N/mm) compared with cross (11.3 N/mm) and double horizontal sutures (10.7 N/mm) (P<.05). There was no significant difference in biomechanical properties between cross and double horizontal sutures. Double vertical sutures showed superior mechanical properties compared with cross and double horizontal sutures in repair of radial meniscal tears, especially in the central zone. These biomechanical properties should be considered when determining appropriate rehabilitation protocols for each suture technique. [Orthopedics. 2019; 42(5):e443-e448.].