Effect of Lesion Location on Fixation Strength of the Meniscal Viper Repair System: An In Vitro Study Using Porcine Menisci

Purpose: The Meniscal Viper Repair System (Arthrex, Naples, FL) is a novel suture-based all-inside meniscal repair system. This study was performed to test whether the Meniscal Viper Repair System would provide superior fixation characteristics for vertical longitudinal meniscal lesions located closer to the periphery compared with those located further away from the periphery. Methods: Vertical longitudinal lesions were created either 1 to 2 mm or 3 to 4 mm away from the periphery of porcine menisci. After repair with the Meniscal Viper Repair System, fixation characteristics were studied during cyclic (500 cycles, 5 to 50 N) and load to failure testing (5 mm/min) in a servo hydraulic device. Results: Meniscal lesion repair location did not show significant differences in displacement or stiffness during cyclic testing. During load to failure testing, meniscal lesion repairs located 1 to 2 mm from the periphery showed superior load at failure (188.8 ± 45.4 N) compared with repairs located 3 to 4 mm from the periphery (114.4 ± 35.0 N) (P = .01). Stiffness and displacement during load to failure testing did not show statistically significant differences. Conclusions: The Meniscal Viper Repair System provides stronger meniscal repair strength when lesions are located within 1 to 2 mm of the periphery. Clinical Relevance: The Meniscal Viper Repair System is better suited for repair of peripheral meniscal lesions located within 1 to 2 mm of the periphery. For lesions located in zone 2 (within the central 50%), careful assessment of their distance from the periphery is recommended. For lesions located more than 3 to 4 mm away from the periphery, alternative repair systems or augmentation with other devices may be prudent.