All-Inside Meniscal Repair: A Historical View
Background: All-inside meniscal repair first became popularized in the early 2000s. Since that time, there has been a wide variety of all-inside implants on the market with rapid changes and developments in recent years. Indications: Small, peripheral, longitudinal tears are best suited for all-insi...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-09-01
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| Series: | Video Journal of Sports Medicine |
| Online Access: | https://doi.org/10.1177/26350254221122614 |
| _version_ | 1798017031492075520 |
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| author | Ian S. MacLean MD Mark D. Miller MD |
| author_facet | Ian S. MacLean MD Mark D. Miller MD |
| author_sort | Ian S. MacLean MD |
| collection | DOAJ |
| description | Background: All-inside meniscal repair first became popularized in the early 2000s. Since that time, there has been a wide variety of all-inside implants on the market with rapid changes and developments in recent years. Indications: Small, peripheral, longitudinal tears are best suited for all-inside repair, but this technique may even be used for large bucket handle tears especially when hybridized with an inside-out repair. Technique Description: A percutaneous release of the medial collateral ligament (MCL) with an 18-g spinal needle is frequently performed when working in the medial compartment to improve visualization and decrease risk of iatrogenic chondral injury. Close familiarity with the characteristics of the chosen all-inside device including device angle, modifiability of device angle, modifiability of needle depth, deployment method, and tensioning technique is important for obtaining reproducible results. Typically, obtaining a vertical mattress stitch configuration is optimal as it captures more circumferential collagen fibers in the repair. Results: Factors to consider when selecting an all-inside meniscal repair device include the ergonomics of the device, implant cost, availability, rigid versus suture-based anchor, core needle diameter, device flexibility, and percent of misfires. Discussion: Complications from use of all-inside meniscus repair devices include device failure, soft tissue entrapment, cyst formation, and injury to the popliteal artery. Outcomes, however, with current devices are good and comparable to inside-out meniscus repair with about a 90% return to sports rate at 12 months postoperatively. The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication. |
| first_indexed | 2024-04-11T16:00:08Z |
| format | Article |
| id | doaj.art-51ce4cae787f4661bc84a8252cae7f9b |
| institution | Directory Open Access Journal |
| issn | 2635-0254 |
| language | English |
| last_indexed | 2024-04-11T16:00:08Z |
| publishDate | 2022-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Video Journal of Sports Medicine |
| spelling | doaj.art-51ce4cae787f4661bc84a8252cae7f9b2022-12-22T04:15:03ZengSAGE PublishingVideo Journal of Sports Medicine2635-02542022-09-01210.1177/26350254221122614All-Inside Meniscal Repair: A Historical ViewIan S. MacLean MD0Mark D. Miller MD1Department of Orthopaedic Surgery, University of Virginia Health System, University of Virginia, Charlottesville, Virginia, USADepartment of Orthopaedic Surgery, University of Virginia Health System, University of Virginia, Charlottesville, Virginia, USABackground: All-inside meniscal repair first became popularized in the early 2000s. Since that time, there has been a wide variety of all-inside implants on the market with rapid changes and developments in recent years. Indications: Small, peripheral, longitudinal tears are best suited for all-inside repair, but this technique may even be used for large bucket handle tears especially when hybridized with an inside-out repair. Technique Description: A percutaneous release of the medial collateral ligament (MCL) with an 18-g spinal needle is frequently performed when working in the medial compartment to improve visualization and decrease risk of iatrogenic chondral injury. Close familiarity with the characteristics of the chosen all-inside device including device angle, modifiability of device angle, modifiability of needle depth, deployment method, and tensioning technique is important for obtaining reproducible results. Typically, obtaining a vertical mattress stitch configuration is optimal as it captures more circumferential collagen fibers in the repair. Results: Factors to consider when selecting an all-inside meniscal repair device include the ergonomics of the device, implant cost, availability, rigid versus suture-based anchor, core needle diameter, device flexibility, and percent of misfires. Discussion: Complications from use of all-inside meniscus repair devices include device failure, soft tissue entrapment, cyst formation, and injury to the popliteal artery. Outcomes, however, with current devices are good and comparable to inside-out meniscus repair with about a 90% return to sports rate at 12 months postoperatively. The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.https://doi.org/10.1177/26350254221122614 |
| spellingShingle | Ian S. MacLean MD Mark D. Miller MD All-Inside Meniscal Repair: A Historical View Video Journal of Sports Medicine |
| title | All-Inside Meniscal Repair: A Historical View |
| title_full | All-Inside Meniscal Repair: A Historical View |
| title_fullStr | All-Inside Meniscal Repair: A Historical View |
| title_full_unstemmed | All-Inside Meniscal Repair: A Historical View |
| title_short | All-Inside Meniscal Repair: A Historical View |
| title_sort | all inside meniscal repair a historical view |
| url | https://doi.org/10.1177/26350254221122614 |
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