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Archives of Orthopaedic and Trauma Surgery

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Open Access 07-06-2023 | Arthroscopic Meniscal Repair | Arthroscopy and Sports Medicine

Greater rate of return to play and re-injury following all-inside meniscal repair compared to the inside-out technique: a systematic review

Authors: Filippo Migliorini, Giovanni Asparago, Francesco Oliva, Andreas Bell, Frank Hildebrand, Nicola Maffulli

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2023

Abstract

Introduction

Inside-out and all-inside arthroscopic meniscal repairs are widely performed. However, it remains unclear which method promotes greater clinical outcomes. This study compared inside-out versus all-inside arthroscopic meniscal repair in terms of patient-reported outcome measures (PROMs), failures, return to play, and symptoms.

Methods

This systematic review was conducted in accordance with the PRISMA guidelines. Two authors independently performed the literature search by accessing the following databases: PubMed, Google Scholar, and Scopus in February 2023. All clinical studies which investigated the outcomes of all-inside and/or inside-out meniscal repair were considered.

Results

Data from 39 studies (1848 patients) were retrieved. The mean follow-up was 36.8 (9 to 120) months. The mean age of the patients was 25.8 ± 7.9 years. 28% (521 of 1848 patients) were women. No difference was found in PROMs: Tegner Activity Scale (P = 0.4), Lysholm score (P = 0.2), and International Knee Document Committee score (P = 0.4) among patients undergoing meniscal repair with all inside or inside-out techniques. All-inside repairs showed a greater rate of re-injury (P = 0.009) but also a greater rate of return to play at the pre-injury level (P = 0.0001). No difference was found in failures (P = 0.7), chronic pain (P = 0.05), reoperation (P = 0.1) between the two techniques. No difference was found in the rate of return to play (P = 0.5) and to daily activities (P = 0.1) between the two techniques.

Conclusion

Arthroscopic all-inside meniscal repair may be of special interest in patients with a particular interest in a fast return to sport, while, for less demanding patients, the inside-out suture technique may be recommended. High-quality comparative trials are required to validate these results in a clinical setting.

Level of Evidence

Level III, systematic review.

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Title: Greater rate of return to play and re-injury following all-inside meniscal repair compared to the inside-out technique: a systematic review
Authors: Filippo Migliorini
Giovanni Asparago
Francesco Oliva
Andreas Bell
Frank Hildebrand
Nicola Maffulli
Publication date: 07-06-2023
Publisher: Springer Berlin Heidelberg
Keywords: Arthroscopic Meniscal Repair
Arthroscopy
Arthroscopy
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2023
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-04933-8

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Greater rate of return to play and re-injury following all-inside meniscal repair compared to the inside-out technique: a systematic review

Abstract

Introduction

Methods

Results

Conclusion

Level of Evidence

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Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Level of Evidence

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