Can Suture Tape Improve Radial Meniscal Tear Repair Over Traditional Suture? A Biomechanical Cadaveric Study

Background: While studies have demonstrated that the “hashtag” suture pattern may improve biomechanical repair properties in radial meniscal tears, the effect of the type of suture within the hashtag is unknown. Hypothesis/Purpose: The purpose of this study was to evaluate the repair strength of the hashtag repair using suture tape compared to traditional 2-0 suture. It was hypothesized that suture tape, particularly in the “rebar” portion of the hashtag repair, would significantly increase construct strength compared to traditional 2-0 suture. Study Design: Controlled laboratory study. Methods: Complete radial tears were made at the midbody of 28 fresh-frozen adult lateral menisci. Specimens underwent hashtag repair with 1 of 4 different suture configurations: all 2-0 suture (2-0), all suture tape (tape), suture tape as the rebar and 2-0 suture as the horizontal component (hybrid v1), or 2-0 suture as the rebar and suture tape as the horizontal component (hybrid v2). Specimens were loaded in a tensile testing system and cyclically loaded for 500 cycles before load-to-failure testing. Load-to-failure (N), stiffness (N/mm), and mechanism of failure were recorded. Data were analyzed using analysis of variance with the Tukey multiple comparisons test. Results: Tape constructs demonstrated significantly higher load-to-failure compared to 2-0 constructs (189.8 ± 16.1 N vs 145.6 ± 39.6 N; P = .0357). There was no significant difference between tape and hybrid v1 constructs (189.8 ± 16.1 N vs 191.2 ± 31.8 N; P = .9997). Hybrid v2 constructs failed at significantly lower loads (141.9 ± 19.7 N) compared to both tape and hybrid v1 repairs (P = .0205 and P = .0167, respectively). Hybrid v1 constructs also showed significantly higher stiffness (16.4 ± 2.3 N/mm) compared to 2-0 (13.2 ± 2.8 N/mm) and hybrid v2 (12.7 ± 1.7 N/mm) constructs (P = .0497 and P = .0182, respectively). Conclusion: Suture tape increased the hashtag repair strength and stiffness in radial meniscal tears in cadaveric menisci, with the improved strength attributed to suture tape in the rebar limb. The horizontal suture type did not significantly affect construct strength or stiffness. These data suggest that suture tape may significantly improve the biomechanical repair strength of hashtag radial meniscal tear repairs. Clinical Relevance: Radial meniscal tears are difficult to repair and are associated with poor prognosis, necessitating further research into optimal repair constructs.