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Review
. 2024 Jul 1:9:29.
doi: 10.21037/aoj-24-4. eCollection 2024.

All-inside suture meniscal repair using suture passer

Ryohei Uchida  1 , Shuji Horibe  2 , Tomoki Ohori  3 , Konsei Shino  4
Affiliations
Review

All-inside suture meniscal repair using suture passer

Ryohei Uchida et al. Ann Jt. .

Abstract

In recent years, to save the meniscus and prevent the progression of knee osteoarthritis, the indications for meniscus repair have been expanding instead of partial menisectomy. Accordingly, various repair techniques for meniscus tears have been developed. The conventional inside-out and outside-in meniscus repair techniques and all-inside repair technique with an implant/anchor can be classified as trans-capsular (TC) repair from the perspective of suture with penetrating capsule. Recently, new suture passers for all-inside meniscus repair have been developed. To distinguish from conventional all-inside repair with implant/anchors, all-inside repair with only suture using these suture passers was described as all-inside suture (AIS) repair. This AIS repair could achieve meniscus-to-meniscus suture across the tear without interposition of soft tissues including the capsule between suture and meniscus, leading direct gap closing of torn edges. In this respect, AIS repair is considered to be "anatomical meniscus repair". Actually, some reports showed biomechanical and clinical advantages of AIS repair. However, there is still limited evidence in clinical practice. Moreover, there are some disadvantages for AIS repair. Not only further studies but also development of new devices and surgical techniques for AIS should be required. This review describes the current status of AIS repair for each type of tear.

Keywords: All-inside suture repair (AIS repair); meniscus repair; repair techniques; suture passer.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://aoj.amegroups.com/article/view/10.21037/aoj-24-4/coif). T.O. serves as an unpaid editorial board member of Annals of Joint from August 2023 to July 2025. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
New classification of meniscal repair. In middle column, there are illustrations showing different repair techniques and suture/implant location of each technique. Left column shows conventional “all-inside repair” technique including both all-inside techniques with implants and suture passer as well as suture hook. On the other hand, right column shows two repair techniques, trans-capsular and all-inside suture repair techniques, newly classified from the perspective of suture with penetrating capsule.
Figure 2
Figure 2
Meniscal tear patterns. Illustrations showing appearances of different meniscal tears.
See this image and copyright information in PMC

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