Meta-analysis on biomechanical properties of meniscus repairs: are devices better than sutures?

被引:35
作者
Buckland, Daniel M. [1 ,2 ]
Sadoghi, Patrick [3 ]
Wimmer, Matthias D. [4 ,5 ]
Vavken, Patrick [1 ,2 ,6 ,7 ]
Pagenstert, Geert I. [1 ,2 ]
Valderrabano, Victor [1 ,2 ]
Rosso, Claudio [1 ,2 ]
机构
[1] Univ Basel Hosp, Dept Orthopaed, CH-4031 Basel, Switzerland
[2] Univ Basel, Basel, Switzerland
[3] Med Univ Graz, Dept Orthopaed Surg, Graz, Austria
[4] Univ Hosp Bonn, Dept Orthopaed Surg, Bonn, Germany
[5] Univ Bonn, Bonn, Germany
[6] Harvard Univ, Sch Med, Dept Orthoped Surg, Sports Med Res Lab,Childrens Hosp Boston, Boston, MA 02115 USA
[7] Harvard Univ, Sch Publ Hlth, Harvard Ctr Populat & Dev Studies, Boston, MA 02115 USA
关键词
Meniscus; Repair; Biomechanics; Load-to-failure; Stiffness; Devices; WEIGHT POLYETHYLENE SUTURE; FAILURE STRENGTHS; IN-VITRO; MEDIAL MENISCUS; PULL-OUT; KNEE; ARROW; MENISCECTOMY; SYSTEMS; DISTRACTION;
D O I
10.1007/s00167-014-2966-9
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Meniscal repair devices have been extensively tested during the past decades as reported in the literature. Reviewing the different meniscal repair devices and sutures with their respective biomechanical properties. For this meta-analysis, we conducted a systematic online search using PubMed, EMBASE, CCTR, and CINAHL using the search terms Meniscus OR Meniscal AND Biomechanics AND Repair). Load-to-failure (LtF), stiffness, and cyclic outcome measures were extracted independently and in duplicate. The systematic search revealed 841 manuscripts in total. After exclusion of duplicates and irrelevant publications, 41 studies remained for final analysis. The studies were published in English and German from 1995 to 2013. Due to differing cyclic force protocols, cyclic outcomes had to be excluded. Overall, sutures had a higher LtF [suture: 87.7 +/- A 0.3 N (weighted mean +/- A standard error), device: 56.3 +/- A 0.1 N] and stiffness (suture: 8.9 +/- A 0.04 N/mm, device: 8.6 +/- A 0.04 N/mm) than devices, both p < 0.05. In LfT testing, PDS 0 Vertical (145.0 +/- A 8.1 N), OrthoCord 2-0 (143.6 +/- A 11.3 N), and Ethibond No 0 Vertical (133.4 +/- A 7.7 N) were the strongest sutures and Meniscal Viper (140.9 +/- A 5.1 N), MaxFire Vertical (136.2 +/- A 11.3 N), and FasT-Fix Vertical (115.2 +/- A 1.6 N) were the strongest devices. Second-generation devices were significantly stronger and stiffer than first-generation devices (p < 0.001). Suture repair remains the gold standard with a vertically oriented suture configuration showing superior LtF values compared to a horizontal configuration. Nevertheless, some meniscal repair devices have similar biomechanical properties to suture repairs. Both suture repairs and devices have a place in meniscal restoration. None, meta-analysis of controlled laboratory studies.
引用
收藏
页码:83 / 89
页数:7
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