A new, all-inside technique for meniscus repair

A new method for arthroscopic meniscal repair using sutures with multiple knots was developed, and its mechanical strength was evaluated. Sutures are passed arthroscopically through the torn meniscus using a needle with a cleft in its tip, and when the needle is withdrawn, knots are placed both in the meniscus and the joint capsule. Our method does not require additional skin incisions and can be performed for repair of posterior tears. Furthermore, this all-inside technique minimizes the risk of popliteal neurovascular injury. Biomechanical analysis using bovine menisci showed that the maximum frictional force between the suture and meniscus was greater than the maximum strength of a suture itself. Our method is simple and rapid, making it easy to insert multiple sutures to achieve adequate stability.