Meniscal Repair

Yoon, Kyoung Ho; Park, Keun Ho

doi:10.5792/ksrr.2014.26.2.68

Cited by 42 publications

(41 citation statements)

References 75 publications

(114 reference statements)

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“…6,15 In those considered eligible for repair, the inside-out technique was considered the "gold standard" for arthroscopic meniscal repair, particularly as it is versatile and can be used for most tear patterns that involve the posterior horn or body of the meniscus. 5,6,16 However, it may be associated with increased surgical time, as demonstrated by our results. The point at which statistical differences in operative time become clinically relevant is subjective, but it is the authors' opinion that the mean reduction in time of 46.6 minutes as presented by Ahn et al is both statistically and clinically significant, although it is important to note that this is an individual study finding.…”

Section: Discussionsupporting

confidence: 51%

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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Section: Discussionsupporting

confidence: 51%

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

et al. 2018

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“…It has also been proven that both techniques can restore knee biomechanics to a nearly native state, but inside-out meniscal repair can restore the contact area to a nearly native state and peak contact pressure in the range of 0° to 45° knee motion, whereas the all-inside technique restores it in the range of 0° to 60°—the angles usually used in everyday life 6 . However, commonly reported disadvantages of the all-inside technique are implant-related symptoms such as meniscal and chondral lesions, implant migration, and foreign body reactions 2, 7. This is the reason that we recommend use of a suture hook with nonabsorbable sutures for all-inside meniscal repairs.…”

Section: Discussionmentioning

confidence: 99%

Tips and Pearls for All-Inside Medial Meniscus Repair

Malinowski¹,

Góralczyk

Hermanowicz

et al. 2019

Arthroscopy Techniques

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The medial meniscus is one of the most commonly injured structures in the knee. When the importance of its proper function is well understood, an adequate management in meniscus tear is a key issue for whole knee joint well-being. Although it has been proven that meniscal repairs have better long-term results than meniscectomy, there is still no consensus as to which suturing technique is the best. An all-inside technique seems to allow for the most anatomic repairs with the greatest preservation of surrounding soft tissues. Our aim is to show that there are no technical limits for all-inside meniscal repairs with nonabsorbable sutures. We describe the technique and some tricks for medial meniscus repair in this Technical Note.

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“…The inside-out technique demonstrated clinical success rates between 73% and 91% in multiple retrospective studies. 50 The outside-in technique, introduced by Warren et al, provided an alternative repair technique 51,52 (►Fig. 3b).…”

Section: Operative Goals and Optionsmentioning

confidence: 99%

“…In a systematic review of outside-in repairs, the overall reoperation rate was 25%. 52,53 The all-inside repair techniques were developed with these advantages in mind: lack of additional incisions, decreased neurovascular injury risk, decreased operative time, and ability to access tears of the posterior root (►Fig. 3c).…”

Section: Operative Goals and Optionsmentioning

confidence: 99%

The Postoperative Meniscus: Anatomical, Operative, and Imaging Considerations

Cordle

Williams

Andrews

2018

Semin Musculoskelet Radiol

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Meniscal surgery is commonplace. Patients who have had prior surgery may return for additional imaging for continued or new pain, limited range of motion, or interval injury. Accurate interpretation of postoperative imaging requires a clear understanding of the normal meniscal anatomy and biomechanics. Surgical goals and current surgical techniques impact the imaging appearance. These techniques are reviewed in the context of the various meniscal tear patterns. Multiple imaging modalities may be used in patient assessment with magnetic resonance (MR) imaging providing key information regarding the integrity of the meniscal repair. Imagers need to be aware of the key findings for a normal versus pathologic appearance to the postoperative meniscus as well as other potential MR findings that may account for patient presentation.

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Meniscal Repair

Cited by 42 publications

References 75 publications

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

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

Tips and Pearls for All-Inside Medial Meniscus Repair

The Postoperative Meniscus: Anatomical, Operative, and Imaging Considerations

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