Kopf S. Am J Sports Med. 2011. doi: 10.1177/0363546511413250
Use of the modified Kessler stitch in the treatment of meniscal root tear repair brings about the most satisfactory results when compared to loop stitching or two simple stitches, according to this study from researchers in Pittsburgh.
The authors noted, however, that while the Kessler stitch provides the strongest results in repairing meniscal root tears, none of the methods examined restored the strength of native meniscal roots — thus, they wrote, postoperative rehabilitation should proceed with caution.
In this study, the authors tested the maximum failure load of the four native meniscal roots — anterolateral, posterolateral, anteromedial and posteromedial — through examination of 64 meniscal roots. Further, the authors tested maximum failure loads of three fixation techniques — two simple stitches, the modified Kessler stitch and the loop stitch with a suture shuttle — on 24 meniscal roots.
Average maximum failure load of the native meniscal roots, the authors found, was 594 N. The anterolateral root’s average maximum failure load was 692 N, with the posterolateral, anteromedial and posteromedial average maximum failure loads coming in at 648 N, 407 N and 678 N, respectively.
“The anteromedial root was significantly weaker than the posterolateral and posteromedial roots,” the authors wrote.
Fixation results found the average maximum failure load of the two simple stitches technique to be 64.1 N, with the modified Kessler stitch displaying an average maximum failure load of 142.6 N and the loop’s average maximum failure load coming in at 100.9 N — none of which matched the strength of the native roots.