The evolution of all-inside meniscal repair

Abstract

Since the preservation of the meniscus became a well-established hallmark of knee surgery, all-inside meniscal repair has undergone an important evolution as arthroscopic techniques have improved. All of these innovations must stand up against the gold standard that remains inside-out repair. This chapter gives an overview of the four generations of all-inside meniscal repair devices that have evolved, from cumbersome suture hooks and arthroscopic knot tying techniques to sleek combinations of suture, slip knot, and peripheral anchors, all in one device. These new, all-inside, meniscal repair techniques and implants do offer distinct advantages over older all-inside methods. However, incorrect insertion, even in experienced hands, can result in chondral abrasions and penetration of neurovascular structures and even the skin. Good comparative and prospective studies are needed in this rapidly growing field of Orthopaedics.