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All-Inside Meniscal Repair: A Historical View.

Ian S MacLean1, Mark D Miller1

  • 1Department of Orthopaedic Surgery, University of Virginia Health System, University of Virginia, Charlottesville, Virginia, USA.

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|May 1, 2025
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Summary

All-inside meniscal repair offers good outcomes, comparable to inside-out techniques, with a high return to sports rate. Careful device selection and surgical technique are crucial for successful meniscus repair.

Keywords:
all-insideall-suture implantscomplicationsmeniscusoutcomesrepairrigid implants

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomedical Engineering

Background:

  • All-inside meniscal repair techniques have evolved significantly since the early 2000s.
  • A wide array of all-inside implants are now available, with recent rapid advancements.
  • These implants are designed to address various meniscal tear types, from small peripheral tears to larger bucket-handle tears.

Purpose of the Study:

  • To review the current landscape of all-inside meniscal repair devices and techniques.
  • To highlight key considerations for device selection and surgical implementation.
  • To discuss potential complications and compare outcomes with traditional methods.

Main Methods:

  • Review of current literature and available all-inside meniscal repair devices.
  • Discussion of surgical techniques, including percutaneous medial collateral ligament (MCL) release and optimal stitch configurations.
  • Analysis of factors influencing device selection and potential complications.

Main Results:

  • All-inside repair is suitable for various meniscal tears, especially when combined with inside-out techniques for complex tears.
  • Key device selection factors include ergonomics, cost, anchor type, and device mechanics.
  • Outcomes are generally good, with approximately 90% return to sports at 12 months, comparable to inside-out repairs.

Conclusions:

  • All-inside meniscal repair is a viable and effective technique with good patient outcomes.
  • Careful consideration of device characteristics and surgical technique is essential for successful repair.
  • Potential complications, though present, do not negate the overall positive results of modern all-inside devices.