A modified outside-in meniscal repair technique

Modified Outside-In Plus Suture Technique for Repair of the Anterior and Middle Segments of the Meniscus: Technical Note

“…Penetration of the capsule only parallel to the joint line with a spinal needle is easier than penetration of both the capsule and the meniscus proper, which is relatively resistant when performing an outside-in technique, thus sometimes causing chondral damage. When suturing the outer rim of the tear site similar to the traditional outside-in technique, 9 passing the suture first under the inferior margin of the meniscus, that is, between the meniscus and tibia, it is easier to orient the spinal needle than to pass the suture between the meniscus and femoral condyle. This is a result of the tibial condylar articular surface being oriented parallel to the inferior surface of the meniscus.…”

Outside-In Meniscus Repair

“…[35][36][37] This can be in the form of another spinal needle loaded with another suture loop or a commercially available wire cable loop device. [35][36][37] This can be in the form of another spinal needle loaded with another suture loop or a commercially available wire cable loop device.…”

“…36 Laupattaarakasem et al 37 described a method to repair the meniscus through the same subcutaneous hole. This technique is a modification where the suture is passed into the wire loop within the knee joint.…”

Alternative method of outside–in meniscal repair for anterior horn tears

“…The outside–in technique, described by Morgan and Casscells, is best indicated for ruptures of the middle or anterior meniscal third and avoids the occasional neurovascular complications of the inside–out techniques. 3 The all-inside technique is especially useful in posterior horn ruptures, and due to the narrow articular space, it can be technically difficult to perform. The development of devices for suture passage has made the technique progressively easier, with the advantage of not requiring additional skin incisions.…”