Suture Anchor Fixation of the Pediatric Posteromedial and Posterolateral Menisco-Tibial Ligament Complex Matches or Exceeds Native Tissue Strength: A Cadaveric Study

Ian Hollyer; Thomas Johnstone; Amin Alayleh; Willemijn vanDeursen; Kelly McFarlane; Wills Baird; Calvin Chan; Marc Tompkins; Henry Ellis; Ted Ganley; Yi-Meng Yen; Seth Sherman; Kevin Shea

doi:10.1016/j.jisako.2025.100385

Suture Anchor Fixation of the Pediatric Posteromedial and Posterolateral Menisco-Tibial Ligament Complex Matches or Exceeds Native Tissue Strength: A Cadaveric Study

J ISAKOS. 2025 Jan 9:100385. doi: 10.1016/j.jisako.2025.100385. Online ahead of print.

Authors

Ian Hollyer¹, Thomas Johnstone², Amin Alayleh³, Willemijn vanDeursen⁴, Kelly McFarlane⁵, Wills Baird⁶, Calvin Chan⁷, Marc Tompkins⁸, Henry Ellis⁹, Ted Ganley¹⁰, Yi-Meng Yen¹¹, Seth Sherman¹², Kevin Shea¹³

Affiliations

¹ Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA. Electronic address: [email protected].
² Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA. Electronic address: [email protected].
³ Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA. Electronic address: [email protected].
⁴ Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA. Electronic address: [email protected].
⁵ Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA. Electronic address: [email protected].
⁶ Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA. Electronic address: [email protected].
⁷ Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA. Electronic address: [email protected].
⁸ Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA. Electronic address: [email protected].
⁹ Department of Orthopedic Surgery, Scottish Rite Hospital for Children, Frisco, Texas, USA. Electronic address: [email protected].
¹⁰ Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: [email protected].
¹¹ Department of Orthopedic Surgery, Harvard University, Boston, Massachusetts, USA. Electronic address: [email protected].
¹² Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA. Electronic address: [email protected].
¹³ Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA. Electronic address: [email protected].

PMID: 39798603
DOI: 10.1016/j.jisako.2025.100385

Abstract

Objectives: To compare the biomechanical strength and stiffness of the native posteromedial and posterolateral meniscotibial ligament complex (MTLC) to suture anchor repair of the MTLC.

Methods: 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.

Results: The load-to-failure for the posteromedial suture anchor construct was significantly higher than 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 MTLC failed at the meniscus-MTLC interface. The suture anchor groups had various failure modes, including suture pullout and breakage.

Conclusion: 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.