Inside-outside and all-inside meniscus repair: indications, techniques, and results
Repair of meniscus tears help to preserve its significant load-bearing function and maintain its role in joint stability. Both functions of the meniscus are necessary to avoid early degenerative changes frequently observed after meniscectomy. The inside-out arthroscopic-assisted meniscal repair technique was developed by Henning. It features: (1) meniscal and meniscosynovial abrasion to promote vascular healing; (2) cannulated suture-needle delivery system for suture placement; and (3) a posteromedial or lateral skin incision for needle retrieval to avoid neurovascular complications. This is a versatile technique permitting repair of nearly all longitudinal lesions. For extremely peripheral tears within the posterior horn of the meniscus, Morgan has described an arthroscopic all-inside technique. No skin incision is necessary, but the ability to tie knots arthroscopically is a prerequisite. This procedure is like the open peripheral meniscus repair described by DeHaven, but it is performed arthroscopically. The indications and technical details of both these methods for meniscal repair is emphasized. Important clinical, anatomic, and surgical factors are correlated with second-look arthroscopy after meniscal repair. © 1995 W. B. Saunders Company.
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