Initial tension at suture fixation affects the suture breakage following medial meniscus posterior root repair: a retrospective cohort study

ObjectivesThis study aimed to investigate whether the initial suture tension when pullout sutures are fixed affects postoperative clinical outcomes following medial meniscus posterior root repair.MethodsThe data of 48 patients who underwent transtibial pullout repair using two simple stitches (outer and inner sutures) with an additional all-inside posteromedial pullout were retrospectively investigated. The patients were sequentially divided into two groups to compare the clinical efficacy of the initial pullout tension when pullout sutures were fixed: the 30N Group (April 2019 to September 2019, 24 patients) and the 15N group (October 2019 to February 2020, 24 patients). The rate of suture breakage (suture cutout or rupture) at the second-look arthroscopy at 1 year postoperatively and clinical outcomes at 2 years postoperatively were compared between the two groups.ResultsIn both groups, each clinical score significantly improved at 2 years postoperatively. At the second-look arthroscopy, the rate of posteromedial suture breakage was significantly higher in the 30 N Group (19 patients, 79%) than in the 15 N Group (10 patients, 42%); the rate of outer suture breakage was also higher in the 30 N group (five patients, 21%) than in the 15 N group (no patients). On comparing 2 years of preoperative clinical scores between the groups categorized according to posteromedial suture breakage, the pain score was significantly higher in the suture breakage group.ConclusionThe initial tension of pullout repair of the medial meniscus posterior root tear is related to suture breakages. To prevent suture breakage, 15 N is a more initially suitable condition than 30 N.Level of evidenceLevel III.