Arthroscopic Meniscal Repair: “Modified Outside-In Technique”

Background:  Despite the introduction of different techniques for meniscal repair, no single procedure is superior in all situations. The new method for meniscal repair named “ modified outside-in technique ” aims to achieve higher primary fixation strength by an alternative suture technique as well as avoid disadvantages of outside-in, inside-out, and all-inside suture procedures. Additionally, the mid-term results of surgically treated patients with  eniscal injuries by our new technique were evaluated. Methods:  The current prospective study included ۶۶ patients who underwent meniscal repair by the modified outside-in technique. The International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form was completed pre- and post-operatively. At final follow-up, Lysholm score was completed and patients were questioned about their return to previous sport activities. Clinical success was defined as lack of swelling and joint line tenderness, absence of locking, negative McMurray test and no need for meniscectomy. Patients’ satisfaction was evaluated using the visual analogue scale (VAS). Patients were followed for ۲۶±۱.۷ months.  Results:  Clinical success was achieved in ۶۱ patients (۹۲.۴%) and ۵ candidates required meniscectomy (۷.۶%). IKDC Subjective Knee Evaluation Form score increased significantly from ۵۴.۲±۱۲.۷ preoperatively to ۹۰.۸±۱۵.۶  postoperatively (P<۰.۰۰۱). Lysholm score was excellent and good in ۴۹ (۸۰.۳%) patients and fair in ۱۲ (۱۹.۷%). Patients’ satisfaction averaged at ۸.۳۵±۱ (۶-۱۰). Neurovascular injury, synovitis and other knot-related complications were not reported. Conclusions:  The modified outside-in technique has satisfactory functional and clinical outcomes. We believe that this procedure is associated with better clinical and biomechanical results; however, complementary studies should be performed to draw a firm conclusion in this regard.    

Keywords:

Arthroscopy , Meniscus , Modified outside-in technique