Novel Suture Technique Improves Meniscal Repair

A new arthroscopic repair technique for radial meniscal tears leaves 89% of patients free of meniscal symptoms 24 months after surgery, according to a new study.

Researchers from the department of orthopedic surgery at Osaka University Medical School (Japan) conducted a study of 42 knees treated surgically for radial tears of either the lateral or the medial meniscus. The study included radial meniscal tears of five types, classified by size and shape. Patients were evaluated for subjective symptoms. Surgery was performed using the new Tie-Grip repair technique, which places an inside-out vertical suture parallel to each edge of the radial tear. Several horizontal mattress sutures, two to three mm long, bridge the tear and tie the grips together.

The researchers reported that 65% of the patients had complete healing, while 29% had partial healing. The healing rate depended on the blood supply or cells in the meniscus, stability, and intrinsic healing capacity. Healing rate did not vary significantly with patient age or time from injury to repair. The findings were reported at the 74th annual meeting of the American Academy of Orthopedic Surgeons, held during February 2007 in San Diego (CA, USA).

"I've tried all inside sutures or outside sutures. They worked sometimes, but it's not consistent. Tie-Grip is more consistent,” said lead author Ken Nakata, M.D. "You need to use a horizontal mattress suture for a radial tear, but a horizontal mattress suture alone never puts the ends together because the sutures run parallel to the circumferential fibers. It's very weak. We put the vertical sutures in first, to prevent slipping of the horizontal sutures.”


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Osaka University Medical School