BACKGROUND: There are no reports comparing meniscal healing between inside-out and all-inside repairs using sutures. HYPOTHESIS: No difference in healing rate exists between meniscal repairs with inside-out and all-inside suture repair in conjunction with anterior cruciate ligament reconstruction with hamstring tendon. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Forty-eight consecutive patients underwent meniscal repairs of longitudinal tears of the posterior horn of the medial meniscus combined with anterior cruciate ligament reconstructions. All-inside repair was attempted when the tears were located in the red-red zone or the ramp area of the meniscus. If a tear that was in the ramp area or red-red zone extended to the midbody of the meniscus, or if there was a tear in red-white zone, the inside-out repair technique was used. Fourteen patients had all-inside meniscal repairs, and 34 patients had inside-out meniscal repairs with absorbable sutures. Identical postoperative rehabilitation protocols were used. Postoperative evaluations included Lysholm knee scoring scale, Tegner activity levels, Lachman and pivot-shift tests, and KT-1000 arthrometer. Assessment of meniscal status was performed using joint line tenderness, McMurray test, and range of motion. Follow-up magnetic resonance imaging scans were obtained on all patients. RESULTS: Mean follow-up was 35.7 months. No patient had joint line tenderness or reported pain or clicking on McMurray test. There was no significant difference in range of motion between groups. Follow-up magnetic resonance imaging scans demonstrated that 10 (71.4%) menisci were healed and 4 (28.6%) partially healed in the all-inside group; 24 (70.6%) menisci were healed and 10 (29.4%) partially healed in the inside-out group. There was no significant difference in meniscal healing between groups. There were no differences in Lachman test, KT-1000 arthrometer side-to-side differences measurements, Lysholm scores, and Tegner activity scales. There was a significant difference in pivot-shift test between groups (P = .023). There were 2 complications associated with surgery. In the inside-out group, 1 patient required manipulation, and 2 patients had limited motion at final follow-up. Two patients in the inside-out group experienced transient saphenous nerve injury. CONCLUSION: There was no significant difference in meniscal healing between inside-out and all-inside repair techniques in combination with anterior cruciate ligament reconstructions.
BACKGROUND: There are no reports comparing meniscal healing between inside-out and all-inside repairs using sutures. HYPOTHESIS: No difference in healing rate exists between meniscal repairs with inside-out and all-inside suture repair in conjunction with anterior cruciate ligament reconstruction with hamstring tendon. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Forty-eight consecutive patients underwent meniscal repairs of longitudinal tears of the posterior horn of the medial meniscus combined with anterior cruciate ligament reconstructions. All-inside repair was attempted when the tears were located in the red-red zone or the ramp area of the meniscus. If a tear that was in the ramp area or red-red zone extended to the midbody of the meniscus, or if there was a tear in red-white zone, the inside-out repair technique was used. Fourteen patients had all-inside meniscal repairs, and 34 patients had inside-out meniscal repairs with absorbable sutures. Identical postoperative rehabilitation protocols were used. Postoperative evaluations included Lysholm knee scoring scale, Tegner activity levels, Lachman and pivot-shift tests, and KT-1000 arthrometer. Assessment of meniscal status was performed using joint line tenderness, McMurray test, and range of motion. Follow-up magnetic resonance imaging scans were obtained on all patients. RESULTS: Mean follow-up was 35.7 months. No patient had joint line tenderness or reported pain or clicking on McMurray test. There was no significant difference in range of motion between groups. Follow-up magnetic resonance imaging scans demonstrated that 10 (71.4%) menisci were healed and 4 (28.6%) partially healed in the all-inside group; 24 (70.6%) menisci were healed and 10 (29.4%) partially healed in the inside-out group. There was no significant difference in meniscal healing between groups. There were no differences in Lachman test, KT-1000 arthrometer side-to-side differences measurements, Lysholm scores, and Tegner activity scales. There was a significant difference in pivot-shift test between groups (P = .023). There were 2 complications associated with surgery. In the inside-out group, 1 patient required manipulation, and 2 patients had limited motion at final follow-up. Two patients in the inside-out group experienced transient saphenous nerve injury. CONCLUSION: There was no significant difference in meniscal healing between inside-out and all-inside repair techniques in combination with anterior cruciate ligament reconstructions.
Authors: Giles Heilpern; Jo Stephen; Simon Ball; Andrew Amis; Andy Williams Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-05-12 Impact factor: 4.342
Authors: J T K Melton; J R Murray; A Karim; H Pandit; F Wandless; N P Thomas Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-04-09 Impact factor: 4.342
Authors: Jason L Koh; Todd A Zimmerman; Savan Patel; Yupeng Ren; Dali Xu; Li-Qun Zhang Journal: Clin Orthop Relat Res Date: 2018-11 Impact factor: 4.176
Authors: Allicia Ostoposides Imada; James J O'Hara; Ignacio L Proumen; Pablo S Molinari; Daniel C Wascher; Dustin L Richter; Robert C Schenck Journal: Int Orthop Date: 2021-05-29 Impact factor: 3.075