Outside-in Repair Technique is Effective in Traumatic Tears of the Meniscus in Active Adults: a Systematic Review

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2023 Jun 14

PMID 37314454

Authors

Filippo Migliorini

Marco Pilone

Andreas Bell

Michael Celik

Christian Konrads

Nicola Maffulli

Affiliations

Soon will be listed here.

Abstract

Purpose: Meniscal injuries are common. Outside-in meniscal repair is one of the techniques advocated for the management of traumatic meniscal tears. This systematic review investigated the outcomes of the outside-in repair technique for the management of traumatic tears of the menisci. The outcomes of interest were to investigate whether PROMs improved and to evaluate the rate of complications.

Methods: Following the 2020 PRISMA statement, in May 2023, PubMed, Web of Science, Google Scholar, and Embase were accessed with no time constraints. All the clinical investigations which reported data on meniscal repair using the outside-in technique were considered for inclusion. Only studies which reported data on acute traumatic meniscal tears in adults were considered. Only studies which reported a minimum of 24 months of follow-up were eligible.

Results: Data from 458 patients were extracted. 34% (155 of 458) were women. 65% (297 of 458) of tears involved the medial meniscus. The mean operative time was 52.9 ± 13.6 min. Patients returned to their normal activities at 4.8 ± 0.8 months. At a mean of 67-month follow-up, all PROMs of interest improved: Tegner scale (P = 0.003), Lysholm score (P < 0.0001), International Knee Documentation Committee (P < 0.0001). 5.9% (27 of 458) of repairs were considered failures. Four of 186 (2.2%) patients experienced a re-injury, and 5 of 458 (1.1%) patients required re-operation.

Conclusion: Meniscal repair using the outside-in technique can be effectively performed to improve the quality of life and the activity level of patients with acute meniscal tears.

Level Of Evidence: Level IV.

Citing Articles

Outside-In-Outside Repair Technique for Anterior Horn and Body Meniscal Tear: A Modified Technique.

Cao G, Shi X, Wang X, Yang L, Tan H Arthrosc Tech. 2024; 13(9):103057.

PMID: 39308580 PMC: 11411366. DOI: 10.1016/j.eats.2024.103057.

Meniscus Tears in Elite Athletes: Treatment Considerations, Clinical Outcomes, and Return to Play.

Marigi E, Davies M, Marx R, Rodeo S, Williams 3rd R Curr Rev Musculoskelet Med. 2024; 17(8):313-320.

PMID: 38833135 PMC: 11219605. DOI: 10.1007/s12178-024-09907-w.

Lateral Meniscus Zip Lesion of Knee: Classification and Repair Methods.

Gupta S, Dwivedi A, Chavan S, Gupta P Arthrosc Tech. 2024; 13(4):102911.

PMID: 38690337 PMC: 11056721. DOI: 10.1016/j.eats.2024.102911.

Meniscectomy is associated with a higher rate of osteoarthritis compared to meniscal repair following acute tears: a meta-analysis.

Migliorini F, Schafer L, Bell A, Weber C, Vecchio G, Maffulli N Knee Surg Sports Traumatol Arthrosc. 2023; 31(12):5485-5495.

PMID: 37812251 PMC: 10719156. DOI: 10.1007/s00167-023-07600-y.

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