All-inside suture device is superior to meniscal arrows in meniscal repair: a prospective randomized multicenter clinical trial with 2-year follow-up

Kise, Nina Jullum; Drogset, Jon Olav; Ekeland, Arne; Sivertsen, Einar Andreas; Heir, Stig

doi:10.1007/s00167-014-3423-5

Cited by 27 publications

(23 citation statements)

References 27 publications

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“…The studies were subsequently split in half to determine significance by chi-square. Studies 2,16,22,24,30,36,40,42 with an average or median follow-up duration of <30 months (53%; n = 8) had significantly lower rates of failure than studies 8,23,31,34,35,37,39 with an average or median follow-up duration of >30 months (47%; n = 7) ( P = .016) (Table 5).…”

Section: Resultsmentioning

confidence: 99%

“…Most of the studies included in this review were retrospective or prospective case series. Specifically, 1 study 23 was level 1 evidence, 4 studies 24,35,36,40 were level 3, and 10 studies ∥ were level 4. The MCMS average was 54.4 ± 12 (range, 39-78), with the majority falling in the “fair” range (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Six different devices were used in these studies; the Meniscal Repair System fastener (MRSf) (Mitek Products) was used in 1 study, 24 as was the Biofix Arrow 23 (Bionx Implants Ltd). PDS II (polydioxanone) sutures (Ethicon) were used in 2 studies, 2,16 the RapidLoc device (DePuy Mitek) was used in 3 studies, 8,31,39 a FasT-Fix device (Smith & Nephew) was used in 4 studies, 23,34,35,37 and Meniscus Arrows were used in 5 studies 22,30,36,40,42 (Table 1). Both first and second generations of the FasT-Fix device and Meniscus Arrow were utilized in the studies.…”

Section: Resultsmentioning

confidence: 99%

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All-Inside Repair of Bucket-Handle Meniscal Tears: Clinical Outcomes and Prognostic Factors

et al. 2020

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Background: There is no consensus on technique of choice for repair of bucket-handle meniscal tears (BHMTs). Purpose: To determine factors that affect patient outcomes and failure rates in patients undergoing all-inside repairs of BHMTs. Study Design: Systematic review. Methods: A systematic review of 3 databases using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed. All English-language literature from 1993 to 2019 describing clinical outcomes for patients undergoing all-inside BHMT repair with ≥12-month follow-up was reviewed by 2 independent reviewers. Patient characteristics (patient sex, age), intraoperative factors (laterality, concomitant procedures, surgical technique, implants utilized), and postoperative outcomes (failure rates) were analyzed. Study quality was evaluated with the Modified Coleman Methodology Score (MCMS). Results: Fifteen studies (1 level 1, 4 level 3, 10 level 4) with 763 total patients (64% male; average age, 26.4 years [range, 9-58 years]; average follow-up, 39.8 months [range, 12-120 months]) including 396 all-inside BHMT repairs were included. Six devices were used for repair including the Meniscal Repair System, FasT-Fix, Meniscus Arrow, Biofix Arrow, RapidLoc device, and PDS II suture, with failure rates of 13.5%, 22.4%, 27.1%, 42.9%, 45.2%, and 0%, respectively. The overall repair failure rate was 29.3% at an average of 13.0 months (range, 5.0-32.4 months), but 19.0% for devices still in use. The RapidLoc and Biofix Arrow had higher failure rates than other devices ( P = .0003). Women (31%) were less likely to experience a failure than were men (69%) ( P = .03). Longer follow-up duration resulted in higher failure rates (>30 months, 34.4%; <30 months, 23.4%; P = .016). In 4 studies reporting on both all-inside and inside-out repairs, no significant differences in failure rates were observed. No significant differences in failure rates were found between medial and lateral repairs nor repair with and without concurrent anterior cruciate ligament reconstruction ( P > .05 for all). The overall average MCMS was 54.4 ± 12. Conclusion: The overall failure rate after all-inside repair of BHMTs is 29.3% at an average of 13.0 months, with no difference in failure rates between medial and lateral meniscal repairs. The variables shown to negatively affect the failure rates were the RapidLoc and Biofix Arrow, male sex, and longer follow-up duration.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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All-Inside Repair of Bucket-Handle Meniscal Tears: Clinical Outcomes and Prognostic Factors

et al. 2020

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“…Because of this, all-inside repair may represent a more heterogeneous technique and may not accurately reflect the most recent generation of all-inside devices. Clinical results may be improving concurrently with improvements to all-inside devices, 22 and this may subject our study to bias and overestimation of the failure rates of all-inside repairs. The American Journal of Sports Medicine Further, studies included without technique randomization are subject to selection bias for repair type.…”

Section: Discussionmentioning

confidence: 99%

All-Inside Versus Inside-Out Meniscal Repair With Concurrent Anterior Cruciate Ligament Reconstruction: A Meta-regression Analysis

et al. 2016

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“…The authors found that the arrow group had a significantly higher relative risk of reoperation (3.6 times; 95% CI, 1.1-11.5), but functional outcomes were comparable at mean 2 years' follow-up. 26 However, longer-term outcome data have shown high failure rates with the use of the suture anchor systems. For example, Solheim et al evaluated outcomes in 82 patients at a minimum of 7 years and demonstrated a 48% failure rate with the use of the RapidLoc system.…”

Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of Arthroscopic Meniscal Repair: Inside-Out versus Outside-In versus All-Inside Techniques

et al. 2018

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Meniscal repair has been introduced to preserve knee function and limit the accelerated degenerative changes associated with meniscal tissue resection. Arthroscopic techniques have evolved to improve morbidity. However, there are few clinical outcome studies in the peer-reviewed literature that compare the use of these approaches. Therefore, our purpose was to perform a meta-analysis of the existing literature on arthroscopic meniscal repair techniques. Specifically, we evaluated differences in: (1) operating time; (2) incidence of postoperative meniscal healing; (3) functional outcomes, using various scoring systems; and (4) incidence of complications. We searched the peer-reviewed literature using SCOPUS, Medline, EMBASE, and Web of Science. Eight studies were eligible for the meta-analysis. These included one prospective, randomized trial (level I), three prospective, comparative studies (level II), and four retrospective, comparative studies (level III). There were a total of 476 patients who had a mean follow-up between 3 and 156 months. When evaluating objective outcomes, the inside-out technique had a significantly higher mean operating time than the all-inside technique. The inside-out and all-inside techniques had comparable meniscal healing rates, but the outside-in repair had a significantly higher rate of meniscal healing than the all-inside repair. Upon assessment of functional outcomes, the inside-out and all-inside methods had comparable International Knee Documentation Committee and Tegner activity scores, but the all-inside method had greater improvements in Lysholm scores. The inside-out and all-inside repairs had similar overall complication rates. All-inside repair may demonstrate lower operating times, but the outside-in repair may have superior meniscal healing rates. Functional outcomes are overall comparable between the techniques. However, there are limited clinical data on the outcome differences between these procedures, and further comparative studies with longer follow-up are needed.

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All-inside suture device is superior to meniscal arrows in meniscal repair: a prospective randomized multicenter clinical trial with 2-year follow-up

Cited by 27 publications

References 27 publications

All-Inside Repair of Bucket-Handle Meniscal Tears: Clinical Outcomes and Prognostic Factors

All-Inside Repair of Bucket-Handle Meniscal Tears: Clinical Outcomes and Prognostic Factors

All-Inside Versus Inside-Out Meniscal Repair With Concurrent Anterior Cruciate Ligament Reconstruction: A Meta-regression Analysis

A Meta-Analysis of Arthroscopic Meniscal Repair: Inside-Out versus Outside-In versus All-Inside Techniques

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