Delta Grip Stitch enhances Fixation Strength in Medial Meniscus Posterior Root Tear Repair: Study
Medial meniscal posterior root (MMPR) tears (MMPRTs) have been increasingly recognized as impairing the transmission of circumferential hoop stress. In MMPRTs, the critical biomechanical functions of the meniscus are disrupted, leading to accelerated arthritic degeneration, abnormal loading, instability and the potential need for knee arthroplasty, particularly in younger patients.
Kyohei Ishibashi et al conducted a study to compare the biomechanical properties of four meniscal suture configurations—two simple sutures (TSS), two cinch sutures, a locking loop stitch (LLS), and a delta‐grip stitch (DGS)—for transtibial pullout repair of medial meniscus posterior root tears (MMPRTs) using porcine menisci.
Forty porcine menisci were randomly assigned to each suture configuration with all‐inside repair. All specimens were subjected to cyclic loading for 1000 cycles, followed by a load‐to‐failure test. The authors evaluated displacement after cyclic loading, the ultimate failure load and the mode of failure.
Key findings of the study:
• No suture breakage was observed during the cyclic loading tests.
• No significant differences in displacement were observed between the configurations (p = 0.709).
• The mean displacement was 10.1 ± 1.6, 11.2 ± 3.3, 12.4 ± 3.3 and 12.2 ± 4.4mm in the TSS, TCS, LLS and DGS groups, respectively.
• The DGS exhibited significantly higher ultimate failure loads (281.4 ± 53.5 N) compared to TSS (166.8 ± 84.5 N) and the LLS (119.7 ± 46.7 N) (p = 0.006 and p < 0.001, respectively).
• Suture breakage was observed in the DGS group, while meniscus cutout was observed in the other suture configuration models.
“In conclusion, our study highlights the potential of using the DGS technique as a promising option for transtibial pullout repair of MMPRTs, offering superior fixation strength compared with conventional suture configurations. However, further research addressing the limitations of this study is necessary to establish the clinical relevance and applicability of the DGS in the management of MMPRTs” – the authors opined.
Level of Evidence: Level IV.
Further reading:
Biomechanical comparison of all‐inside meniscal suture configurations for posterior root tear: Three conventional stitches versus delta‐grip stitch
Kyohei Ishibashi et al
J Exp Orthop. 2025;12:e70149.
https://doi.org/10.1002/jeo2.70149
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