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

Elmallah, Randa K.; Jones, LaRita C.; Malloch, Lacy; Barrett, Gene R.

doi:10.1055/s-0038-1668123

Cited by 39 publications

(36 citation statements)

References 31 publications

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“…13,102,104 Meniscal repairs have been associated with good clinical outcomes overall, 45,81,143 and for isolated meniscal repairs there has been no difference in clinical outcomes between all-inside versus inside-out repairs. 41,42,48,49,67,90 Meniscal root repairs were shown to be cost-effective, to be associated with high rates of complete or partial healing, and to lessen the progression of arthrosis. 44,46,64 Substantial evidence has shown good clinical outcomes after MAT and high survival rates, although studies may have been biased and RCTs are lacking.…”

Section: Discussionmentioning

confidence: 99%

An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses

Smoak

Matthews

Vinod

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: A large number of systematic reviews and meta-analyses regarding the meniscus have been published. Purpose: To provide a qualitative summary of the published systematic reviews and meta-analyses regarding the meniscus. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of all meta-analyses and systematic reviews regarding the meniscus and published between July 2009 and July 2019 was performed with PubMed, CINAHL, EMBASE, and the Cochrane database. Published abstracts, narrative reviews, articles not written in English, commentaries, study protocols, and topics that were not focused on the meniscus were excluded. The most pertinent results were extracted and summarized from each study. Results: A total of 332 articles were found, of which 142 were included. Included articles were summarized and divided into 16 topics: epidemiology, diagnosis, histology, biomechanics, comorbid pathology, animal models, arthroscopic partial meniscectomy (APM), meniscal repair, meniscal root repairs, meniscal allograft transplantation (MAT), meniscal implants and scaffolds, mesenchymal stem cells and growth factors, postoperative rehabilitation, postoperative imaging assessment, patient-reported outcome measures, and cost-effectiveness. The majority of articles focused on APM (20%), MAT (18%), and meniscal repair (17%). Conclusion: This summary of systematic reviews and meta-analyses delivers surgeons a single source of the current evidence regarding the meniscus.

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Section: Discussionmentioning

confidence: 99%

An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses

Smoak

Matthews

Vinod

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…Also, it increases stability of the remnant meniscus which can be achieved if the two leaves heal together, unlike the instability of single laminae alone without fixation from the coronary ligament and knee joint capsule. The most important point is that it is truly allinside and the intracapsular procedures may avoid injuring the adjacent extracapsular structures [20,21].…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic all-inside repair with suture hook for horizontal tear of the lateral meniscus at the popliteal hiatus region: a preliminary report

Fang

Liu

et al. 2020

BMC Musculoskelet Disord

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Background: Arthroscopic surgery procedures vary depending on the types of meniscus tear, including meniscectomy and meniscus repair. Among the several types of meniscus tear, the horizontal tear of the lateral meniscus at the popliteal hiatus region is a common injury, and its surgical treatment is still inconsistent. patients who underwent all-inside repair with suture hook for the horizontal tear of the lateral meniscus at the popliteal hiatus region were recruited. Any operative complication was recorded, and postoperative MRI scans were conducted at the 6 months. The clinical results were graded based on the scale of the Lysholm knee score preoperatively and at follow-up. Results: No operative complications were recorded. Postoperative MRIs at the 6 months showed that there was no re-tear for all patients, though signal intensity remained high in T2-weighted MRI in the lateral meniscus for nine cases. The average preoperative Lysholm knee score was 58.6 ± 10.1, which increased significantly to 89.3 ± 7.8 (t = − 11.01, p = 0.001) at the last follow-up. Recurrence or aggravation of symptoms was not noted at the final followup. Conclusion: All-inside repair with suture hook may be a good option for the horizontal tear of the lateral meniscus at the popliteal hiatus region which preserves the meniscus; avoids iatrogenic injury on the adjacent popliteal tendon, common peroneal nerve, and inferior lateral geniculate artery.

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“…Among the repair methods of meniscus injury [18] , meniscal suture repair is the mainstream repair method at present, and includes three types of repair: outside-in repair, inside-out repair and all-inside repair. Although the technique of inside-out repair is the gold standard for the treatment of the body and posterior angle of the meniscal tear, clinical studies have shown [19][20][21][22] that the clinical efficacy of all-inside repair is the same as that of inside-out repair, where all-inside repair has shorter operation time and fewer complications. Therefore, the method of all-inside repair for meniscal tear of the body or posterior angle has seen increasing use [23][24][25] .…”

Section: Discussionmentioning

confidence: 99%

The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair

Shi

Fan

et al. 2019

Preprint

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Background: In consideration of meniscal repair has received increasingly more attention, but for inexperienced doctors, various technical errors may occur when meniscal suture repair is performed, particularly during all-inside meniscal suture repairing. When the errors is happened intraoperatively, how to minimize the loss under the effectiveness of treatment is a topic worth studying. Methods: From May 2014 to May 2017, 28 cases diagnosed with injures of meniscus and anterior cruciate ligaments were enrolled in the study as observation group. All cases underwent anterior cruciate ligament (ACL) reconstruction concurrently. All meniscus injuries were repaired with an allinside meniscal repair technique, and 1-3 needles of unilateral suture anchor pulling out occurred intraoperatively. The method of modified cross-suture was used to remedy the error of anchor pulling out and to eventually complete the effective repair. During postoperative follow-up, the range of motion, Lachman test and pivot shift test were confirmed by physical examination. The clinical healing of meniscus was evaluated according to the Barrett standard. Meniscus healing status was also confirmed with magnetic resonance imaging (MRI). The function of the knee joint was evaluated with the IKDC, Lysholm and Tegner scores. Results: 25 cases of observation group and 28 cases of control group received complete follow-up with an average follow-up of 18.4±5.2 months. All operations were finished by the same surgeon. Atthe follow-up one year after operation, the average knee ROM of two groups were 125.2±4.3 degrees and 124.7±3.8 degrees, the clinical healing rate of the meniscus of two groups were 92.0% (23/25) and 92.9% (26/28), the MRI healing rate of the menniscus of two groups were 72.0% (18/25) and 71.4% (20/28), the IKDC, Lysholm and Tegner scores of two groups were 90.52±2.8, 89.17±3.1, 6.81±1.7 and 91.42±1.9, 90.32±3.4, 7.02±1.4, the differences were not statistically significant (P>0.05).Conclusions: The method of modified cross-suture is effective for arthroscopic remediation for unilateral suture anchor pulling out of an all-inside meniscal repair system. BackgroundMeniscus injury is a kind of common and frequent sports injury, and its treatment should maintain the

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

Cited by 39 publications

References 31 publications

An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses

An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses

Arthroscopic all-inside repair with suture hook for horizontal tear of the lateral meniscus at the popliteal hiatus region: a preliminary report

The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair

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