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Review
. 2022 Aug;15(4):252-258.
doi: 10.1007/s12178-022-09766-3. Epub 2022 Jun 4.

All-Inside Meniscus Repair

A G Golz  1 , B Mandelbaum  2 , J L Pace  3
Affiliations
Review

All-Inside Meniscus Repair

A G Golz et al. Curr Rev Musculoskelet Med. 2022 Aug.

Abstract

Purpose of review: The indications for partial meniscectomy are becoming increasingly limited, and recent evidence suggests that the meniscus should be preserved whenever possible. Because of its many proposed advantages, all-inside meniscus repairs are becoming increasingly common. This review discusses the indications, advantages, disadvantages, and biomechanical and clinical outcomes of all-inside meniscus repair.

Recent findings: All-inside meniscus repair demonstrates equal functional outcomes, healing rates, and complications compared to inside-out repair of vertical longitudinal and bucket-handle tears with the advantages of decreased surgical time and faster post-operative recovery. In addition, return-to-sport and activity levels are high following all-inside repair regardless of whether concomitant anterior cruciate ligament reconstruction is performed. Biomechanical studies have demonstrated advantages of all-inside meniscal based repairs on radial and horizontal tears. All-inside meniscus repair compares favorably to inside-out repair of vertical longitudinal and bucket-handle tears and continues to increase in popularity. Both capsular based and meniscal based repairs can be used to repair a variety of tear patterns. While biomechanical results are encouraging, further research on the clinical outcomes of meniscal based repairs is needed to elucidate the role of these techniques in the future.

Keywords: All-inside meniscus repair; Capsular based meniscus repair; Meniscal based meniscus repair; Meniscus.

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Conflict of interest statement

Andrew Golz declares that he has no conflict of interest. Lee Pace declares that he is a consultant for Arthrex and JRF and is a committee member for the Pediatric Research in Sports Medicine (PRiSM) Society. Bert Mandelbaum declares that he is a consultant and receives royalties from Arthrex and is on the board of Cedars-Sinai Kerlan-Jobe institute.

Figures

Fig. 1
Fig. 1
Arthroscopic images of an all-inside capsular based repair on a 17-year-old female with a right knee medial meniscus tear. a Posterior horn vertical meniscus tear in the red-red zone near the menisco-capsular junction after medial collateral ligament fenestration. b Partial repair with sutures placed in both the superior and inferior meniscal surfaces. c Completed repair with a total of four sutures placed
Fig. 2
Fig. 2
Arthroscopic images of an all-inside meniscal based repair on a 13-year-old female with a left knee medial meniscus tear. a Posterior horn vertical meniscus tear in the red-white zone demonstrating instability with probing. b Improved visualization following medial collateral ligament fenestration. c Suture passage using the Knee Scorpion. d Completed meniscal based repair
See this image and copyright information in PMC

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