Combined Inside-Out and All-Inside Technique in Bucket-Handle Meniscus Tears

Abstract

Objective: To determine the outcomes after combined inside-out and all-inside repair technique of bucket-handle meniscus tears. Methods: A retrospective review was made of patients with bucket-handle meniscus tears repaired with combined techniques, using the all-inside technique in posterior meniscal tears and the inside-out technique in the middle part of the meniscal tears. Meniscal healing was assessed clinically using Barrett's criteria and MRI. Results: The study comprised 52 patients with a mean age of 28.4 years old (range, 19-52 years old). The mean follow-up period was 31.3 months (range, 24-59 months). Two patients had ACL re-rupture, and complete meniscal healing was achieved in all but one patient. Although improved from preoperative status, Tegner and Lysholm scores were lower in the ACL reconstructed patients than in the intact ACL patients. Conclusion: Combined inside-out and all-inside meniscal repair technique is a successful and cost-effective treatment method in bucket-handle meniscus tears. Level of Evidence IV, Therapeutic Study.

Arthroscopically Repaired Bucket-Handle Meniscus Tears: Patient Demographics, Postoperative Outcomes, and a Comparison of Success and Failure Cases

“…For comparison, other publications have reported even greater success in outcomes: Yilmaz et al . 31 noted complete meniscal healing in all but one of 52 patients (mean age = 28.4 years) who underwent a combined inside-out and all-inside technique for repair of bucket-handle meniscus tears at a mean 31.3-month follow-up. Ahn et al .…”

“…For comparison, other publications have reported even greater success in outcomes: Yilmaz et al 31 noted complete meniscal healing in all but one of 52 patients (mean age = 28.4 years) who underwent a combined inside-out and allinside technique for repair of bucket-handle meniscus tears at a mean 31.3-month follow-up. Ahn et al 32 retrospectively evaluated 13 patients with a median age of 20 years at a median 4.0 years follow-up after modified all-inside or combination all-inside/outside-in repair of lateral meniscus bucket-handle tears.…”

Arthroscopic Procedure for Chronic Isolated Bucket-Handle Meniscal Tears

“…We used a combined inside-out and all-inside modality with multiple suturing techniques to ensure stable and adequate fixation. This approach was approved as being appropriate by many researchers 1,2,[12][13][14][15] ; however, some authors have recorded better outcomes with all-inside repairs when compared with inside-out repairs. 12 Our assertion was similar to those of Yilmaz et al, 13 who found out that combined CHRONIC ISOLATED BUCKET-HANDLE MENISCAL TEAR e5 inside-out and all-inside meniscal repair technique is a successful and cost-effective treatment method in bucket-handle meniscus tears.…”

Vertical Continuous Meniscal Suture Technique

“…24 Among the most popular devices that assist the surgeon in meniscal repairs from the inside-out, we can mention the malleable needles attached to the suture thread, which have the disadvantage of needing 1 device for each suture, making the repair very costly. 25 There are malleable needles with a lumen that allow the use of a single kit in >1 point; however, these cannulas are fragile and sometimes crush and obstruct their lumen during use, requiring often 2 devices to repair extensive injuries. 2,26 We herein describe the meniscal suture technique using the Meniscus 4-All device, which is resistant and allows countless stitches with a single device (Table 1).…”