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Inside-Out Meniscal Repair: Still a Useful Technique.
Anis Tebourbi1, Rami Triki1, Mouadh Nefiss1
1Department of Orthopedic Surgery, Mongi Slim Hospital, La Marsa, Tunisia.
Video Journal of Sports Medicine
|May 1, 2025
Summary
The inside-out meniscal repair technique offers comparable results to newer all-inside devices, making it a viable option for low-income countries. This surgical method provides a cost-effective solution for large meniscal tears.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- All-inside meniscal repair devices are preferred by surgeons but are costly.
- The inside-out technique offers an economical alternative with comparable outcomes.
- Economic factors in low-income countries necessitate cost-effective surgical solutions.
Purpose of the Study:
- To describe a modified inside-out meniscal repair technique using resorbable sutures.
- To evaluate the efficacy and outcomes of this modified technique for bucket-handle meniscal tears.
Main Methods:
- A modified inside-out technique using a Menghini needle and polydioxanone (PDS) resorbable suture was employed.
- Sutures were passed vertically through the meniscus to create a stable repair.
- Postoperative management allowed a full range of motion at 6 weeks.
Main Results:
- 33 bucket-handle meniscal tears were repaired between January 2017 and June 2020.
- The average International Knee Documentation Committee (IKDC) score improved from 49.6 to 86.2.
- A short-term success rate of 91% was achieved, comparable to all-inside devices.
Conclusions:
- The modified inside-out meniscal repair is a reliable technique with good outcomes.
- It presents a cost-effective alternative to all-inside devices, particularly for resource-limited settings.
- While time-consuming and requiring an assistant, the technique yields excellent results.
