An arthroscopic repair technique for meniscal tear using a needle and suture: outside-in transfer all-inside repair

Wang, Zhiqiang; Xiong, Yan; Tang, Xin; Li, Qi; Zhong, Zhang; Li, Jian; Chen, Gang

doi:10.1186/s12891-019-2984-3

“…30 However, a downside to the outside-in method is the need for an extra 1-2 cm skin incision and tying knots under the skin over the capsule. 31 The "all-inside" technique is another option with good results, but it's not as commonly used because it can be expensive and sometimes lead to nerve or blood vessel issues. There are only a few reports of its use, even for tears in the back part of the meniscus, because it requires larger cuts around the knee and more complex needle and instrument maneuvers.…”

Section: Discussionmentioning

confidence: 99%

Meniscus tears and repair: assessing failure rates of all-inside and outside-in methods

Bliznikas,

Lukoševičiūtė,

Dauderytė

2024

Int J Res Orthop

0

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Meniscal repair procedures are on the rise due to an enhanced understanding of the adverse long-term effects associated with the loss of meniscal tissue. Although meniscal repair has a higher reoperation rates compared to meniscectomy, recent systematic reviews indicate improved long-term outcomes with meniscal repair. Even though there are a lot of studies that compare the results of all-inside and inside-out techniques there are only few that evaluate all-inside and outside-in approaches. This study aims to review the relevant literature on the epidemiology, mechanism of injury, clinical presentation and imaging of meniscus and to compare the failure rates and time to failure of AI and OI meniscal repairs. PubMed and Scopus were searched for studies published between January 2014 and January 2024 reporting on meniscus repair outcomes using “outside-in” or “all-inside” techniques with a minimal duration of 6 months for follow-up. Failure was characterized as the recurrence of clinical symptoms or the need for a meniscal reintervention. Over 50 English-language articles were analyzed between 2000 and 2022. After conducting a review and data analysis, it is observed that the “all-inside” technique is more frequently chosen as a treatment method, possibly due to its simpler execution. Both total and percentage rates of failures are higher using this technique, amounting to 79 cases and reaching 16%, compared to “outside-in” approach, which is less commonly chosen, but has lower frequency of failures totaling 6 cases and 5%.

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“…A new arthroscopic intracapsular suture repair technique called outside-in transfer, all-inside repair was used for Palmer type 1B Atzei class 1 TFCC tears in this study. This new method is a modification of the technique for meniscal tears introduced by Wang et al [20]. This repair technique using arthroscopy provides several advantages to other reported repair techniques.…”

Section: Discussionmentioning

confidence: 99%

A new arthroscopic repair technique for triangular fibrocartilage complex using an intracapsular suture: an outside-in transfer all-inside repair

Zhao,

Lin,

Li

et al. 2023

J Orthop Surg Res

2

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Background Arthroscopic repair is a promising, minimally invasive surgical technique for patients with Palmer type 1B peripheral triangular fibrocartilage complex (TFCC) tears. Although several arthroscopic techniques are effective for repairing Palmer type 1B TFCC tears, some shortcomings remain. So, we report an arthroscopic repair technique for the treatment of Palmer type 1B Atzei class 1 TFCC tears using an intracapsular suture: an outside-in transfer all-inside repair. Methods A retrospective analysis of 38 Palmer type 1B TFCC injury patients admitted to our hospital were randomly divided into 2 groups. The group A was sutured from the outside to the inside, with a total of 21 cases; the group B was sutured with the new arthroscopic repair technique, with a total of 17 cases. Observe and compare the VAS scores and modified Mayo wrist function scores of all patients before 3, and 6 months after the operation and evaluate the incidence of thread knots in patients with different treatment methods. The methodology was performed an arthroscopic intracapsular suture using an outside-in transfer, all-inside repair technique, which is a modified method of the outside-in and all-inside technique using the needle of a 10-mL sterile syringe, for Palmer type 1B TFCC tears. A No. 2 polydioxanone suture was threaded through the needle and entered the wrist joint. Next, the needle was withdrawn carefully along the suture to the proximal tear ulnar surface of the TFCC and penetrated the TFCC, exiting the articular cavity surface of the ulnar side of the torn TFCC. Finally, arthroscopic knotting was performed. Results This new treatment was as effective as the previously arthroscopic techniques and had the advantages of no additional incision and decreased risk of operation-related complications. The incidence of thread knots in the group A (28.57%) was significantly higher than that in the group B (0%), and the difference was statistically significant (P = 0.024). There was no significant difference in VAS score and modified Mayo wrist function scores between the two groups (P > 0.05). Conclusions The outside-in transfer, the all-inside repair technique is suitable for Palmer type 1B Atzei class 1 TFCC tears. We recommend this technique as a useful alternative to the conventional methods of repairing Palmer type 1B TFCC tears.

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“…A new arthroscopic intracapsular suture repair technique called outside-in transfer, all-inside repair was used for Palmer type 1B Atzei class 1 TFCC tears in this study. This new method is a modi cation of the technique for meniscal tears introduced by Wang in 2019 [19]. This repair technique using arthroscopy provides several advantages to other reported repair techniques.…”

Section: Discussionmentioning

confidence: 99%

A new arthroscopic repair technique for triangular fibrocartilage complex using an intracapsular suture: an outside-in transfer, all-inside repair

Zhao

¹

,

Gong

²

,

Bao

³

et al. 2021

Preprint

0

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Background Arthroscopic repair is a promising, minimally invasive surgical technique for patients with Palmer type 1B peripheral triangular fibrocartilage complex (TFCC) tears. Although several arthroscopic techniques are effective for repairing Palmer type 1B TFCC tears, some shortcomings remain; thus, better methods are necessary. Methods We performed an arthroscopic intracapsular suture using an outside-in transfer, all-inside repair technique, which is a modified method of the outside-in and all-inside technique using the needle of a 10-mL sterile syringe, for Palmer type 1B TFCC tears. A No. 2 polydioxanone suture was threaded through the needle and entered the wrist joint. Next, the needle was withdrawn carefully along the suture to the proximal tear ulnar surface of the TFCC and penetrated the TFCC, exiting the articular cavity surface of the ulnar side of the torn TFCC. Finally, arthroscopic knotting was performed. Results This new technique was used to treat 17 patients with Palmer type 1B Atzei class 1 TFCC tears. The treatment was as effective as the previously described arthroscopic techniques and had advantages of no additional incision and decreased risk of operation-related complications. Conclusions The outside-in transfer, all-inside repair is a simple, safe, minimally invasive, and economical procedure that confers a lower risk of complications for Palmer type 1B TFCC tears. We recommend this technique as a useful alternative to the conventional methods of repairing Palmer type 1B TFCC tears.

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An arthroscopic repair technique for meniscal tear using a needle and suture: outside-in transfer all-inside repair

Cited by 8 publications

References 38 publications

Meniscus tears and repair: assessing failure rates of all-inside and outside-in methods

Meniscus tears and repair: assessing failure rates of all-inside and outside-in methods

A new arthroscopic repair technique for triangular fibrocartilage complex using an intracapsular suture: an outside-in transfer all-inside repair

A new arthroscopic repair technique for triangular fibrocartilage complex using an intracapsular suture: an outside-in transfer, all-inside repair

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