Suture Anchor Fixation of the Pediatric Posteromedial and Posterolateral Menisco-Tibial Ligament Complex Matches or Exceeds Native Tissue Strength: A Cadaveric Study.

Objectives: To compare the biomechanical strength and stiffness of the native posteromedial and posterolateral meniscotibial ligament complex (MTLC) to suture anchor repair of the MTLC.

Methods: Biomechanical testing was performed on 24 fresh-frozen pediatric human knees. Four conditions were tested: native posteromedial MTLC (n=14), native posterolateral MTLC (n=14), posteromedial MTLC repair (n=5), and posterolateral MTLC repair (n=5). Load-to-failure and stiffness were measured for all conditions.

Results: The load-to-failure for the posteromedial suture anchor construct was significantly higher than the native MTLC (p < 0.01). The posterolateral suture anchor construct had a significantly greater stiffness than the native MTLC (p = 0.03). Posterolateral MTLC load-to-failure and posteromedial MTLC stiffness were similar between native tissue and suture-anchor repair. All native MTLC failed at the meniscus-MTLC interface. The suture anchor groups had various failure modes, including suture pullout and breakage.

Conclusion: Suture anchor fixation can match or exceed the native tissue's load-to-failure. This study supports the viability of suture anchor-based posterior MTLC repairs of the medial and lateral meniscus in pediatric bone.