Inside-Out Approach to Meniscus Repair: Still the Gold Standard?

Erick M. Marigi, Sara E. Till, Jory N. Wasserburger, Anna K. Reinholz, Aaron J. Krych, Michael J. Stuart

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: The purpose of this review is to provide an up-to-date summary on the current literature and trends regarding use of the inside-out approach to meniscus repair. Additionally, the paper describes the authors preferred techniques for inside-out meniscus repair utilizing posteromedial and posterolateral exposures. Recent Findings: There has been a substantial increase in recent publications regarding meniscus repair. However, comparisons regarding the optimal repair technique have not been conclusive. Despite the recent increase in use of all-inside devices, multiple investigations with short-to-mid-term follow-up have demonstrated similar rates of meniscus healing between inside-out and all-inside repair techniques. Similarly, current literature describes comparable failure rates of around 20%. There are variations in the profile of complications, with all-inside devices having more implant-related complications and inside-out techniques with higher neurovascular injuries. Summary: Inside-out meniscus repair is a versatile, cost-effective technique that remains the gold standard for management of most meniscus tear patterns. Through a thoughtful approach, efficient suture retrieval and repair can be performed while protecting critical neurovascular structures. All-inside meniscus repair devices have increased in popularity and surgeon access, but this technique is not without limitations and comparisons to inside-out meniscus repair demonstrates equivocal outcomes.

Original languageEnglish (US)
Pages (from-to)244-251
Number of pages8
JournalCurrent Reviews in Musculoskeletal Medicine
Issue number4
StatePublished - Aug 2022


  • Inside-out
  • Meniscus
  • Meniscus injuries
  • Meniscus repair
  • Meniscus repair needles
  • Meniscus tears

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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