Suture tapes show superior biomechanical properties and greater meniscal healing compared to conventional sutures in posterior meniscal root tear repairs: A systematic review.
Khalis Boksh, Duncan E T Shepherd, Daniel M Espino, Arijit Ghosh, Tarek Boutefnouchet, Randeep Aujla
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引用次数: 0
Abstract
Purpose: This study aims to perform a systematic review to determine whether ultra-high molecular weight polyethylene (UHMWPE) tapes have superior biomechanical properties compared to conventional sutures in posterior meniscal root tear (PMRT) repairs, and whether this translates into superior clinical outcomes.
Methods: The Cochrane Controlled Register of Trials, PubMed and Embase were used to perform a systematic review using the following search terms: (meniscus OR meniscal) AND (root OR posterior horn) AND (suture OR tape OR wire OR cord). Data pertaining to certain biomechanical properties (load to failure, stiffness, displacement during cyclical loading and at failure), meniscal healing and patient-reported outcome measures (PROMs) were extracted.
Results: Seven biomechanical and two clinical studies were included. There were 232 knees for biomechanical testing: 81 with UHMWPE tapes and 151 with conventional sutures (133 with UHMWPE sutures and 18 with Ethibond [Ethicon]). Testing set-up was similar across studies, but there were differences in repair techniques, including suture configuration, location and method of fixation. In general, the consensus was that tapes had a higher load to failure and stiffness, with similar displacement at failure to that of UHMWPE sutures. A similar trend was also observed when tapes were compared to Ethibond, except for FiberTape (Arthrex). This particular UHMWPE tape showed greater displacement during cyclical loading, resulting from knot slippage. Clinically, there were 73 patients, 41 with UHMWPE tapes and 32 with either UHMWPE sutures (n = 18) or braided polyester sutures (n = 14). Tapes led to greater meniscal healing 1 year postoperatively, with PROMs similar across groups.
Conclusions: UHMWPE tapes generally demonstrated superior biomechanical properties compared to conventional sutures in PMRT repairs with a simple stitch configuration. However, further biomechanical studies are required to determine the extent to which tapes contribute to the repaired construct, especially with more complex repair configurations, as the existing evidence displayed a notable amount of methodological heterogeneity.
Level of evidence: Level IV systematic review of level IV evidence.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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