Published: 2016-12-19

Clinical results of arthroscopic all-inside meniscal repair

Suresh Perumal, Sadem Amer, Prakash Ayyadurai, Sivaraman Arumugam


Background: The meniscus plays a key role in normal knee function. Recently, meniscal repair has become an important mode treatment for meniscal tears. Compared to open surgery, arthroscopic meniscal repair has become popular because of shorter duration of the surgery, the smaller incision and better accessibility to the torn portion, which is particularly difficult during open Surgery. Inside-out, outside-in, and all-inside arthroscopic techniques are widely used. Arthroscopy by all inside meniscal repair has the lowest neurovascular injury rate. In this study we have evaluated clinical outcomes of arthroscopic all inside menisceal repair technique.

Methods: This study prospectively evaluated 24 consecutively treated patients to determine the effectiveness of arthroscopic meniscal repair using the Fast Fix repair system. Average age of patients at the time of surgery was 24.The inclusion criteria for this study were: vertical full thickness tear >10 mm in length; location of the meniscal tear < 6 mm from the menisco-capsular junction, no former meniscus surgery; and no evidence of arthritis during arthroscopy, absence of complex menisceal tear. Anterior cruciate ligament (ACL) deficient knees were reconstructed using a hamstring autograft or BTB graft at the time of the meniscal repair. Follow-up examinations consisted of IKDC score, Lysholm knee score, Tegner activity score.

Results: After an average of 2 years follow-up, no symptoms of meniscal tears were found in 22/24 of the cases. For patients with isolated meniscal repair or concurrent ACL reconstruction, IKDC score, Lysholm and Tegner activity scores had significantly improved postoperatively. One patient had retear for which partial medial meniscectomy was done No neurovascular or other major complications were directly associated with the use of this system.

Conclusions: Arthroscopic all-inside repair using the all inside device appears to be a safe and effective surgery to preserve meniscus.


ACL, Arthroscopic meniscus, Neurovascular complications

Full Text:



Annandale T. An operation for displaced semiluminar car- tilage. Br Med J. 1885;1:779.

Ikeuchi H. Surgery under arthroscopic control. Proceedings of Societe Internationale Arthroscopie. Rheumatology. 1975;14:57-62.

Asik M, Sener N. Failure strength of repair deviced ver- sus meniscus suturing techniques. Knee Surg Sports Traumatol Arthrosc. 2002;10:25-9.

Albrecht-Olsen P, Kristensen G, Burgaard P, Joengersen U, Toerholm C. The arrow versus horizontal suture in arthroscopic meniscus repair. Knee Surg Sports Traumatol Arthrosc. 1999;7:268-73.

Albrecht-Olsen P, Kristensen G, Törmälä P. Meniscus bucket-handle fixation with an absorbable Biofix tack: Development of a new technique. Knee Surg Sports Traumatol Arthrosc. 1993;1:104-6.

Anderson K, Marx RG, Hannafln J, Warren RF. Chondral injury following meniscal repair with a biodegradable implant. Arthroscopy. 2000;16:749-53.

Bonshahi AY, Hopgood P, Shepard CJ. Migration of a broken arrow: A case report and review of the literature. Knee Surg Sports Traumatol Arthrosc. 2004;12:50-1.

Calder S, Myers PT. Broken arrow: A complication of meniscal repair. Arthroscopy. 1999;15:651-2.

Arnoczky SP, Lavagnino M. Tensile fixation strengths of absorbable meniscal repairs as a function of hydrolysis time. Am J Sports Med. 2001;29:118-23.

Asik M, Sener N. Failure strength of repair devices versus meniscus suturing techniques. Knee Surg Sports Traumatol. Arthrosc. 2002;10:25-9.

McDermott ID, Richards SW, Hallam P, Tavares S, Lavelle JR, Amis AA. A biomechanical study of four different meniscal repair systems, comparing pull-out strengths and gapping under cyclic loading. Knee Surg Sports Traumatol. Arthrosc. 2003;11:23-9.

Barrett GR, Field MH, Treacy SH, Ruff CG. Clinical results of meniscus repair in patients 40 years and older. Arthrosc. 1998;14:824-9.

Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with a special emphasis on use of a scoring scale. Am J Sports Med. 1982;10:150-4.

Tegner Y, Lysholm J. Rating system in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1986;198:43-9.

DeHaven KE. Decision-making factors in the treatment of meniscus lesions. Clin Orthop Relat Res. 1990;252:49-54.

Maitra RS, Miller MD, Johnson DL. Meniscal reconstruc- tion: Part I: Indications, techniques, and graft considerations. Am J Orthop. 1999;28:213-8.

Newman AP, Daniels AU, Burks RT. Principles and decision making in meniscal surgery. Arthrosc. 1993;9:33-51.

Jesus L, Benjamin M, Dilworth C. All inside meniscus repair: A systemic review. Clin Orthop Relat Res. 2006;455:134-41.

Asik M, Sen C, Erginsu M. Arthroscopic meniscal repair using T-fix. Knee Surg Sports Traumatol. Arthrosc. 2002;10:284-8.

Kotsovolos ES, Hantes ME, Mastrokalos DS. Results of all-inside meniscal repair with the FasT-Fix meniscal repair system. Arthrosc. 2006;22:3-9.

Andrew L, Anthony A, Joshua H. Meniscal repair using FasT-Fix all-inside menical devices. Arthrosc. 2005;21:167-75.

Morgan CD, Wojtys EM, Casscells CD, Casscells SW. Arthroscopic meniscal repair evaluated by second look arthroscopy. Am J Sports Med. 1991;19:632-8.

Austin KS, Sherman OH. Complications of arthroscopic meniscal repair. Am J Sports Med. 1990;21:864-9.