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"All-Inside" Meniscal Repair Devices

An Experimental Study in the Goat Model

Mark D. Miller, MD^*,, Alex J. Kline and Kerry G. Jepsen, MD

From the Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, the Department of Orthopaedic Surgery, University of Virginia School of Medicine, and the Wilford Hall USAF Medical Center, Lackland Air Force Base, Texas

^* Address correspondence to Mark D. Miller, MD, University of Virginia, Department of Orthopaedic Surgery, PO Box 800159, Charlottesville, VA 22908.

Background: Although the use of "all-inside" absorbable meniscal repair devices has become popular, numerous complications have been reported. The authors applied their well-established goat model to evaluate three "all-inside" meniscal repair devices.

Methods: A "tear" was created in the medial meniscus of both knees in 26 goats. The animals were randomized into four groups, and the meniscus was treated as follows: (A) meniscal repair with Mitek Fastner, (B) meniscal repair with BioStinger, (C) meniscal repair with Mitek Clearfix Screw, and (D) no repair. All animals were sacrificed at 6 months postoperatively, and all specimens were carefully evaluated and results recorded and compared with historical results of meniscal repair with suture in this same animal model.

Results: Meniscal repair results with all three all-inside devices studied were inferior to suture repair. Chondral injury was present in 75% to 100% of repairs with all-inside devices and none of the control specimens.

Discussion/Conclusion: Although new all-inside meniscal repair devices are relatively quick and easy, results may not be as good as with traditional suture techniques. The high rate of chondral injury associated with these devices in the goat model is worrisome for chondral damage in humans, especially in patients with smaller or tighter knees.

Key Words: knee • meniscus • repair • all-inside

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