Wolf, Brian R. MD; Cohen, David B. MD; Rodeo, Scott A. MD
Hospital for Special Surgery
New York, NY
ABSTRACT The majority of meniscal tears that are amenable to repair can be addressed using the outside-in technique of suture repair. The outside-in technique was developed to decrease the morbidity and complications of meniscal repair seen with previous techniques. This method of repair uses a spinal needle that can be very accurately controlled to minimize potential neurovascular injuries. It is applicable to most meniscal tears and can be used in the setting of meniscal allograft transplantation as well. There are some limitations with this technique, however, due to the difficulty in placing sutures perpendicular to far posterior meniscal tears. Close attention should be paid to the anatomic landmarks on the knee while using this technique to avoid complications. This technique allows placement of sutures in any configuration, including vertical and horizontal mattress, with the use of a very small incision to allow tying sutures directly on the capsule. Rehabilitation, including postoperative weight-bearing status, should be individualized depending on location and type of tear as well as concomitant procedures.
Techniques in Knee Surgery: Volume 3(1) March 2004 pp 19-28