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All-Inside Versus Inside-Out Meniscal Repair: A Comparative Study of Healing Rates And Functional Outcomes
Stanzin Sonam1, Manik Rana2, Swar Desai3
1Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Introduction:
Meniscal injuries rank as one of the most frequent knee injuries, which can be repaired through preservation as the best method to maintain knee joint health and prevent long-term joint deterioration. The all-inside and inside-out meniscal repair techniques represent the most commonly used surgical methods for meniscal tissue restoration. The existing research shows ongoing disagreement about which method of treatment produces better healing results and functional improvements, and surgical time efficiency and rate of medical complications.
Materials And Methods:
This prospective comparative study included 50 patients with meniscal tears who underwent arthroscopic repair. Patients were divided into two groups: All-inside repair (n = 25) and inside-out repair (n = 25). Demographic data, tear characteristics, operative time, complications, healing rates, and functional outcomes were assessed. Functional outcomes were evaluated using the Lysholm knee score and the International Knee Documentation Committee (IKDC) score. Patients were followed up for 6 months postoperatively.
Results:
Majority of the patients were aged 26-35 years (38%) with a male predominance (70%). Operative time was significantly lower in the all-inside group (42 ± 6 min) compared to the inside-out group (58 ± 8 min). Meniscal healing was observed in 84% of patients in the all-inside group and 92% in the inside-out group. Functional outcomes improved significantly in both groups, with Lysholm scores increasing to 90 ± 5 (all-inside) and 92 ± 4 (inside-out), and IKDC scores to 88 ± 6 and 90 ± 5, respectively. Complications were fewer in the all-inside group, with no neurovascular injuries reported, whereas the inside-out group had a higher incidence of such complications. Return to pre-injury activity was achieved in 80% of patients overall.
Conclusion:
Both all-inside and inside-out meniscal repair techniques demonstrated excellent healing and functional outcomes. The all-inside technique provided shorter operative time and fewer complications, whereas the inside-out technique showed slightly higher healing rates.
