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. 2025 Jan 22;12(1):e70149.
doi: 10.1002/jeo2.70149. eCollection 2025 Jan.

Biomechanical comparison of all-inside meniscal suture configurations for posterior root tear: Three conventional stitches versus delta-grip stitch

Kyohei Ishibashi  1 , Kyota Ishibashi  1 , Takahiro Tsushima  1 , Eiji Sasaki  1 , Shohei Yamauchi  1 , Yuka Kimura  1 , Yasuyuki Ishibashi  1
Affiliations

Biomechanical comparison of all-inside meniscal suture configurations for posterior root tear: Three conventional stitches versus delta-grip stitch

Kyohei Ishibashi et al. J Exp Orthop. .

Abstract

Purpose: This study aimed to compare the biomechanical properties of four meniscal suture configurations-two simple sutures (TSS), two cinch sutures, a locking loop stitch (LLS), and a delta-grip stitch (DGS)-for transtibial pullout repair of medial meniscus posterior root tears (MMPRTs) using porcine menisci.

Methods: Forty porcine menisci were randomly assigned to each suture configuration with all-inside repair. All specimens were subjected to cyclic loading for 1000 cycles, followed by a load-to-failure test. We evaluated displacement after cyclic loading, the ultimate failure load and the mode of failure.

Results: No significant differences in displacement were observed between the configurations (p = 0.709). The DGS exhibited significantly higher ultimate failure loads (281.4 ± 53.5 N) compared to TSS (166.8 ± 84.5 N) and the LLS (119.7 ± 46.7 N) (p = 0.006 and p < 0.001, respectively). Suture breakage was observed in the DGS group, while meniscus cutout was observed in the other suture configuration models.

Conclusion: The results suggest that the DGS provides superior fixation strength and enhances MMPRT repair outcomes.

Level of evidence: Level IV.

Keywords: all‐inside repair; cinch stitch; delta‐grip stitch; medial meniscus posterior root tear.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Suture configurations. (a) two simple stitches, (b) two cinch stitches, (c) locking loop stitch and (d) delta‐grip stitch.
Figure 2
Figure 2
Set‐up for biomechanical testing. The sutures were fastened to the upper clamp. Each meniscus was attached to the lower clamp at a point 1 cm medial to the medial meniscus posterior root.
Figure 3
Figure 3
Displacement after cyclic load. Comparison of the displacement distances for each suture configuration DGS, delta‐grip strength; LLS, locking loop stitches; TCS, two cinch stitches; TSS, two simple stitches.
Figure 4
Figure 4
Mode of failure. (a) The mode of failure for two simple stitches, (b) two cinch stitches, (c) locking loop stitch and (d) delta‐grip stitch.
Figure 5
Figure 5
Ultimate failure load. Comparison of the ultimate failure load for each suture configuration. DGS, delta‐grip strength; LLS, locking loop stitches; TCS, two cinch stitches; TSS, two simple stitches.
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References

    1. Allaire R, Muriuki M, Gilbertson L, Harner CD. Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am. 2008;90(9):1922–1931. - PubMed
    1. Branch EA, Milchteim C, Aspey BS, Liu W, Saliman JD, Anz AW. Biomechanical comparison of arthroscopic repair constructs for radial tears of the meniscus. Am J Sports Med. 2015;43(9):2270–2276. - PubMed
    1. Cho JH, Song JG. Second‐look arthroscopic assessment and clinical results of modified pull‐out suture for posterior root tear of the medial meniscus. Knee Surg Relat Res. 2014;26(2):106–113. - PMC - PubMed
    1. Chung KS, Ha JK, Ra HJ, Kim JG. Arthroscopic medial meniscus posterior root fixation using a modified Mason‐Allen Stitch. Arthrosc Tech. 2016;5(1):e63–e66. - PMC - PubMed
    1. Feucht MJ, Grande E, Brunhuber J, Burgkart R, Imhoff AB, Braun S. Biomechanical evaluation of different suture techniques for arthroscopic transtibial pull‐out repair of posterior medial meniscus root tears. Am J Sports Med. 2013;41(12):2784–2790. - PubMed