Purpose
To evaluate whether different suture materials in meniscal repair may harm cartilage.
Methods
A preloaded linear friction testing setup including porcine knees with porcine cartilage,
porcine meniscus, and different suture materials (braided nonabsorbable, absorbable
monofilament) was used. Five groups with different tribological pairs were tested:
cartilage on meniscus (control), cartilage on cartilage (control No. 2), and cartilage
on different meniscus sutures (3 groups). Cartilage integrity was analyzed macroscopically
by the India ink method and histologically using Giemsa-eosin–stained undecalcified
methyl methacrylate sections. Cartilage lesions were classified by using a quantitative
scoring system.
Results
The control groups did not show cartilage damage, either macroscopically or histologically.
Loading cartilage with sutured menisci led to significant damage of the superficial
radial and transitional zones with braided nonabsorbable (P = .03) and absorbable monofilament (P = .02) sutures at final examination. Menisci sutured with braided nonabsorbable material
resulted in deeper damage to the cartilage. However, there were no significant differences
between the suture materials. Sutures oriented perpendicular to surface motion led
to a larger defect than parallel-oriented sutures.
Conclusions
Braided nonabsorbable and absorbable monofilament suture materials cause significant
damage to cartilage during long-term cyclic loading in vitro. The extent of damage
depends on suture orientation.
Clinical Relevance
This study provides data on the extent to which different suture materials in meniscus
repair may harm cartilage.
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Article Info
Publication History
Published online: February 08, 2019
Accepted:
November 14,
2018
Received:
July 4,
2018
Footnotes
See commentary on page 1517
The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
