It is safe and effective to use all inside meniscal repair devices for posteromedial meniscal 'ramp' lesions
File(s)
Author(s)
Heilpern, Giles
Stephen, Jo
Ball, Simon
Amis, Andrew
Williams, Andy
Type
Journal Article
Abstract
PURPOSE: Recently, it has been recognized that meniscocapsular ('ramp') lesions of the posterior one-third of the medial meniscus frequently occur during injuries causing ACL rupture, and that these lesions are easily missed at arthroscopy. Furthermore, it is clear that these lesions are biomechanically significant, adding to the deficits caused by ACL rupture, and that their repair can reverse this. The efficacy of an all inside repair technique has been questioned by some authors and by those who advocate a suture shuttle technique via an accessory posteromedial portal. The use of Ultra FastFix and FastFix 360 meniscal repair devices to repair posteromedial meniscocapsular separations was investigated in terms of safe deployment and the effectiveness. Author: Affiliations: Journal instruction requires a country for affiliations; however, these are missing in affiliations [1, 2]. Please verify if the provided country is correct and amend if necessary. METHODS: Twenty cadaveric fresh frozen knees were used-ten in each of two groups. A ramp lesion was created using a Beaver knife. The lesion was then repaired with either 4 Ultra FastFix (Smith and Nephew) or 4 FastFix 360 (Smith and Nephew) meniscal repair devices. The knees were put through a standardized loading cycle consisting of 10 Lachman's tests and ten maximum loading manual anterior drawer tests at 90° of flexion. Each knee was then flexed and extended fully ten times. The specimens were sectioned just proximal to the menisci and each suture anchor identified and its position recorded and photographed. Author: Author details: Kindly check and confirm whether the corresponding author mail id is correctly identified and amend if necessary. RESULTS: In the Ultra FastFix group, a single anchor was found to be in an intra-articular position-a failure rate of 2.5%. In the FastFix 360 group, 5 anchors failed-a 12.5% failure rate. In all cases, the anchors were attached to their suture and so not truly loose within the joint. CONCLUSIONS: This study confirms the safe and effective deployment of an all inside repair device for repair of medial meniscal 'ramp' lesions, and therefore its use is advocated in treating these difficult lesions. Ultra FastFix had the lower failure rate of 2.5%, which the authors believe is acceptable, and makes this device preferable to the FastFix360.
Date Issued
2018-08-01
Date Acceptance
2018-05-03
Citation
Knee Surgery, Sports Traumatology, Arthroscopy, 2018, 26 (8), pp.2310-2316
ISSN
0942-2056
Publisher
Springer Verlag
Start Page
2310
End Page
2316
Journal / Book Title
Knee Surgery, Sports Traumatology, Arthroscopy
Volume
26
Issue
8
Copyright Statement
© 2018 European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA). The final publication is available at Springer via https://link.springer.com/article/10.1007%2Fs00167-018-4976-5.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29752501
PII: 10.1007/s00167-018-4976-5
Subjects
ACL
Knee
Meniscal repair
Meniscus
Publication Status
Published
Coverage Spatial
Germany
Date Publish Online
2018-05-12