Arthroscopic meniscal repair: “Outside-in” technique

Abstract

Only a few years ago, it was standard practice to excise the meniscus with impunity because of the perception that it played little role in the function of the knee. In fact, it was once described as the functionless remains of leg muscle.’ However, over the last several decades, scientific evidence has progressively mounted to substantiate the vital role of the meniscus in the function of the knee. Fairbank was the first to note the frequency of degenerative changes after removal of the meniscus, and partial meniscectomy rapidly supplanted total meniscectomy. Research continued to determine the healing capacity of the torn meniscus. Now, nearly 50 years later, the pendulum of orthopedic popular opinion has swung toward new ways to preserve the injured meniscus. From these efforts, meniscal repair has evolved as a successful technique. The advent of arthroscopy and advanced arthroscopic techniques has made meniscal repair the preferred approach for many meniscal tears. Anatomy, blood supply, function of the meniscus, and indications for meniscal repair are well reviewed elsewhere in this issue. This review will focus on the various techniques for arthroscopically assisted meniscal repair using the “outside-in” approach.