The Hybrid Reversible Suture-Gripping Technique: A Modified Approach for Continuous Meniscal Suturing

The suture-gripping technique (SGT), which uses a suture shuttle, enables unrestricted gripping, accurate needle insertion from inside the joint, and flexible withdrawal of the suture from outside the joint. We considered the possibility of using a continuous suturing technique with this method, and thus, we describe a modified approach, the hybrid reversible SGT, which allows bidirectional suture manipulation and facilitates continuous meniscal suturing. This technique uses the hybrid reversible SGT with locking stitches (baseball stitch) to repair the lateral meniscal tear. Each subsequent stitch is passed beneath the loop of the previous stitch to create a locked continuous suture with stable tension distribution along the repair line. Despite multiple passes, only 2 knots, 1 at each end, are required. This technique combines the flexibility and precision of the SGT with the biomechanical advantages of continuous suturing, providing secure fixation, minimal knot bulk, and efficient meniscal repair. Hybrid reversible SGT represents a practical and versatile evolution of a previously reported technique, extending its applicability to complex meniscal tears.