Suture anchor fixation of the pediatric posteromedial and posterolateral meniscotibial ligament complex matches or exceeds native tissue strength: A cadaveric study.

Abstract

This study aimed to compare the biomechanical strength and stiffness of the native posteromedial and posterolateral meniscotibial ligament complex (MTLC) to suture anchor repair of the MTLC. 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. The load to failure for the posteromedial suture anchor construct was significantly higher than that for 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 MTLCs failed at the meniscus-MTLC interface. The suture anchor groups had various failure modes, including suture pullout and breakage. 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.