A simple cinch is superior to a locking loop for meniscus root repair: a human biomechanical comparison of suture constructs in a transtibial pull-out model.

PURPOSE: To determine the cyclic displacement and ultimate failure loads of two clinically relevant suture configurations for repair of medial and lateral meniscus root tears.
METHODS: A total of 10 matched pair fresh-frozen, human meniscus specimens were randomly assigned to either simple cinch or locking loop meniscus-suture fixation techniques for transtibial pull-out repair in either medial (n = 10 matched pairs) or lateral (n = 10 matched pairs) meniscal root tears. The menisci were subjected to cyclic tensioning at 10-30 N for 1000 cycles at 0.5 Hz, and then post-cycling load to failure was performed at a tensile rate of 0.5 mm/s.
RESULTS: For both the medial and lateral meniscus, there was significantly less displacement with the cinch stitch at 100, 500 and 1000 cycle counts (p < 0.05). In respect to ultimate load, there was no significant difference in type of repair between the two suture configurations. When comparing ultimate load to failure from the medial to the lateral side, the ultimate load to failure was significantly greater for both suture configurations in the lateral meniscus root repair (p < 0.05). However, there was no significant difference in cyclic displacement between the medial and lateral meniscus.
CONCLUSIONS: The cinch stitch was significantly better at resisting displacement compared to the locking loop stitch configuration, and had similar ultimate load to failure. The lateral meniscus root repair construct has higher failure loads compared to the medial meniscus, independent of suture configuration.