Outside‐in repair technique is effective in traumatic tears of the meniscus in active adults: a systematic review

Abstract

Purpose Meniscal injuries are common. Outside-in meniscal repair is one of the techniques advocated for the management of traumatic meniscal tears. This systematic review investigated the outcomes of the outside-in repair technique for the management of traumatic tears of the menisci. The outcomes of interest were to investigate whether PROMs improved and to evaluate the rate of complications. Methods Following the 2020 PRISMA statement, in May 2023, PubMed, Web of Science, Google Scholar, and Embase were accessed with no time constraints. All the clinical investigations which reported data on meniscal repair using the outside-in technique were considered for inclusion. Only studies which reported data on acute traumatic meniscal tears in adults were considered. Only studies which reported a minimum of 24 months of follow-up were eligible. Results Data from 458 patients were extracted. 34% (155 of 458) were women. 65% (297 of 458) of tears involved the medial meniscus. The mean operative time was 52.9 ± 13.6 min. Patients returned to their normal activities at 4.8 ± 0.8 months. At a mean of 67-month follow-up, all PROMs of interest improved: Tegner scale (P = 0.003), Lysholm score (P < 0.0001), International Knee Documentation Committee (P < 0.0001). 5.9% (27 of 458) of repairs were considered failures. Four of 186 (2.2%) patients experienced a re-injury, and 5 of 458 (1.1%) patients required re-operation. Conclusion Meniscal repair using the outside-in technique can be effectively performed to improve the quality of life and the activity level of patients with acute meniscal tears. Level of evidence Level IV.

Lateral Meniscus Zip Lesion of Knee: Classification and Repair Methods

“…Considering the zip is a PL meniscus lesion, the outside and inside-out technique is not convenient to repair at this location. 11 , 12 Therefore, we prefer all-inside techniques, which can be done using all-inside devices, 13 Knee Scorpion, 14 and the PL suture hook method. 15 …”

Meniscectomy is associated with a higher rate of osteoarthritis compared to meniscal repair following acute tears: a meta‐analysis

“…Both the lateral and medial menisci help preserve the knee biomechanics, and are important for shock absorption, joint stability, joint lubrication, and proprioception [ 6 , 66 , 90 ]. Meniscal tears have different aetiologies and injury patterns [ 44 , 47 , 60 ]. First, a distinction is made between acute and degenerative tears [ 39 , 56 ].…”