Biomechanical study using porcine knees for posterior root medial meniscus repair using Arthroscopic direct meniscal extrusion reduction surgery
Renaldi Prasetia, Rio Aditya, Regina Priscilla, Ghuna Arioharjo Utoyo, Hermawan Nagar Rasyid
UNPAD
Abstract
Introduction In meniscal extrusion (ME), the meniscus cannot play its biomechanical role in load distribution and force absorption by dispersing tibiofemoral axial load. Significant ME will increase contact forces that contribute to the advancement of knee osteoarthritis. Arthroscopic direct meniscal extrusion reduction (ADMER) to reduce persistent ME in posterior root medial meniscus (PRMM) repair has been recommended and showed a promising outcome.The aim of this study was to compare the biomechanical properties of conventional PRMM repair with PRMM repair + ADMER technique. Materials & Methods A total of eighteen (18) porcine tibia with attached intact medial meniscus were used and the specimens were randomly assigned to 1 of 3 groups (n = 6 each). The groups included: Control group (C) with healthy medial meniscus, conventional PRMM repair (P) group, and PRMM repair with ADMER technique (AD) group. All specimens underwent testing for static pull-out strength with a servo-hydraulic material testing machine. A maximum pullout-load was applied to the PMMR until failure. Means and standard deviations of pullout strength were compared Results Mean pull-out strength was 1047.19 N (±64.4) for C group, 256.41 N (±54.26) for P group and 367.48 N (±40.5) for AD group. (Table 1) Maximum pull-out strength for PRMM + ADMER was significantly higher compared to P group (p-value 0.006). Conclusion PRMM Repair combined with ADMER technique had biomechanical properties of higher superior pullout strength compared to conventional PRMM repair and lower elastic modulus. However, we did not test its biomechanical properties under cyclic loading and both techniques did not reach the strength of the native healthy medial meniscus.
Keywords: biomechanical study, meniscus repair, meniscus root, meniscus tear
Topic: Orthopaedic Bioengineering