Tensile fixation strengths of absorbable meniscal repair devices as a function of hydrolysis time - An in vitro experimental study

To determine the effect of hydrolysis time on the fixation strength of absorbable meniscal repair devices, adult bovine menisci were repaired with five devices and a suture. The ultimate tensile strength of the repair was then tested in six specimens immediately or after 6, 12, or 24 weeks of incubation at 37 degreesC in a saline solution containing antibiotics, antimycotics, and protease inhibitors. Immediately after implantation the Bionx Meniscus Arrow had a significantly higher failure strength (57.7 +/- 13.8 N) than the Linvatec BioStinger (35.1 +/- 6.7 N), the Innovasive Clearfix screw (34.9 +/- 13 N), the Surgical Dynamics S.D.sorb staple (9.4 +/- 4.6 N), and the Mitek Meniscal Repair System (polydioxanone) (27.2 +/- 6.0 N). However, there was no significant difference between the Bionx Meniscus Arrow and a 2-0 polydioxanone vertical suture (51.6 +/- 2.7 N). The polydioxanone-based implants demonstrated a significant decrease in failure strength at 12 and 24 weeks. Similarly, the Surgical Dynamics S.D.sorb staple lost all fixation strength by 24 weeks. The remaining devices showed no significant loss of failure strength over the 24-week period, suggesting that 24 weeks of hydrolysis does not adversely affect the ultimate holding power of poly L-lactide-based meniscal fixation devices.