Mechanical comparison of meniscal repair devices with mattress suture devices in vitro

We report the load to failure in tensile testing of the MaxFire (TM) meniscal repair system (Biomet Inc, Warsaw, IN) and compare it to other current meniscal repair devices and mattress suture techniques. After creating a longitudinal tear in 42 one-year-old bovine menisci, 7 specimen groups defined by the meniscal repair device, suture, and/or mattress technique used for meniscal repair were randomly established: (Group 1: Fiberwire (TM) vertical mattress (VM), Group 2: Fiberwire (TM) horizontal mattress (HM), Group 3: FasT-Fix (TM) VM, Group 4: FasT-Fix (TM) HM, Group 5: RapidLoc (TM), Group 6: MaxFire (TM) VM, Group 7: MaxFire (TM) HM). After completing the repairs, the meniscal specimens were cyclically pre-loaded before load to failure testing was performed. The mean load to failure for each group was: Fiberwire VM (185 +/- A 41 N), Fiberwire HM (183 +/- A 36 N), FasT-Fix VM (125 +/- A 8 N), FasT-Fix HM (107 +/- A 29 N), RapidLoc (70 +/- A 12 N), MaxFire VM (145 +/- A 44 N), MaxFire HM (139 +/- A 50 N). An analysis of variance demonstrated a significant difference in the mean load to failure (F = 8.31 P < 0.01). Statistically significant differences were seen between both Fiberwire groups verses FasT-Fix HM and Rapid-Loc (P < 0.05). Three modes of failure were observed: suture breakage (17/42, 40.5%), tissue failure (18/42, 42.9%), and knot failure (7/42, 16.7%). 2-0 Fiberwire (TM) VM and HM repairs had the highest load to failure of all groups tested. The load to failure for the MaxFire (TM) meniscal repair system is comparable to other available all-inside meniscal repair systems.