Purpose
To systematically review the literature of return-to-sport outcomes following all-inside
meniscus repair and evaluate whether concomitant anterior cruciate ligament reconstruction
(ACLR) influenced these outcomes.
Methods
A systematic review of the MEDLINE, PubMed, Embase, and Cochrane Registry of Systematic
Reviews databases was performed according to Preferred Reporting Items for Systematic
Reviews and Meta-Analyses guidelines. Two reviewers examined all literature pertaining
to sport outcomes following all-inside meniscal repair. Studies were included if they
had a 12-month minimum follow-up and reported return to sport rate, Tegner, or Knee
injury and Osteoarthritis Outcome Score (KOOS) Sport outcomes. Studies with meniscal
repair techniques other than the all-inside technique were excluded. Studies were
not excluded if they contained patients receiving concomitant ACLR. Study quality
was evaluated with the Methodological Index for Nonrandomized Studies.
Results
Nineteen studies comprising 872 patients were included in this investigation. The
weighted average patient age was 28.7 (range 14.1-42.1) years, and the weighted average
follow-up was 56.0 (range 18.0-155.0) months. The mean Methodological Index for Nonrandomized
Studies score was 14.4 ± 3.7. Ten investigations reported both preoperative (range
2.3-3.5) and postoperative (range 4.0-7.3) Tegner outcomes, with scores at final follow-up
greater in each of the 10 reporting investigations. KOOS Sport outcomes were examined
in 5 investigations, with scores at follow-up ranging from 63.6 to 91. Three studies
reported a return to sport rate ranging from 89.6 to 90% at follow-up. Four investigations
compared sport-related outcomes between isolated meniscal repair and meniscal repair
with concomitant ACLR. Two such studies reported no difference between the 2 cohorts,
1 favored the isolated cohort, and 1 favored the combined cohort.
Conclusions
This systematic review found a 90% return-to-sport rate and high postoperative activity
level following all-inside meniscal repair, as assessed by KOOS Sport and Tegner activity
scales. Further, concurrent ACLR did not significantly affect these outcomes.
Level of Evidence
IV, systematic review of level I-IV studies.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Epidemiology of isolated meniscus tears in young athletes.Orthop J Sports Med. 2015; 3 (2325967115S2325900107)
- Meniscal repair in pediatric populations: A systematic review of outcomes.Orthop J Sports Med. 2019; 7 (2325967119843355)
- Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal tears.Am J Sports Med. 2010; 38: 1542-1548
- A meta-analysis comparing meniscal repair with meniscectomy in the treatment of meniscal tears: The more meniscus, the better outcome?.Knee Surg Sports Traumatol Arthrosc. 2015; 23: 164-170
- Clinical healing rates of meniscus repairs of tears in the central-third (red–white) zone.Arthroscopy. 2014; 30: 134-146
- Sport-specific outcomes after isolated meniscal repair: A systematic review.Knee Surg Sports Traumatol Arthrosc. 2018; 26: 762-771
- Open meniscus repair. Technique and two to nine year results.Am J Sports Med. 1989; 17: 788-795
- Long-term results of open meniscal repair.Am J Sports Med. 1995; 23: 524-530
- Potential market for new meniscus repair strategies: Evaluation of the MOON cohort.J Knee Surg. 2009; 22: 180-186
- Identifying candidates for arthroscopic primary repair of the anterior cruciate ligament: A case-control study.Knee. 2019; 26: 619-627
- Return to play after all-inside meniscal repair in competitive football players: A minimum 5-year follow-up.Knee Surg Sports Traumatol Arthrosc. 2016; 24: 1997-2001
- Clinical results following meniscal sutures: Does concomitant acl repair make a difference?.Acta Orthop Belg. 2015; 81: 690-697
- Comparison of arthroscopic meniscal repair results using 3 different meniscal repair devices in anterior cruciate ligament reconstruction patients.Arthroscopy. 2008; 24: 810-816
- Arthroscopic repair of meniscus tears extending into the avascular zone with or without anterior cruciate ligament reconstruction in patients 40 years of age and older.Arthroscopy. 2000; 16: 822-829
- Meniscal repair.Arthroscopy. 2009; 25: 1033-1044
- Meniscal repair for radial tears of the midbody of the lateral meniscus.Am J Sports Med. 2010; 38: 2472-2476
- Comparison of arthroscopic medial meniscal suture repair techniques: Inside-out versus all-inside repair.Am J Sports Med. 2009; 37: 2144-2150
- Outcome of all-inside second-generation meniscal repair: Minimum five-year follow-up.J Bone Joint Surg Am. 2014; 96: 1303-1307
- Clinical results of all-inside meniscal repair using the FasT-Fix meniscal repair system.Chang Gung Med J. 2011; 34: 298-305
- Suture versus FasT-Fix all-inside meniscus repair at time of anterior cruciate ligament reconstruction.Arthroscopy. 2014; 30: 1280-1286
- Most elite athletes return to competition following operative management of meniscal tears: A systematic review.J ISAKOS. 2018; 3: 110-115
- Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement.PLoS Med. 2009; 6e1000097
- Methodological index for non-randomized studies (minors): Development and validation of a new instrument.ANZ J Surg. 2003; 73: 712-716
- RoB 2: A revised tool for assessing risk of bias in randomised trials.BMJ. 2019; 366: l4898
- Arthroscopic repair of the medial meniscus radial/oblique tear prevents the progression of meniscal extrusion in mildly osteoarthritic knees.Acta Med Okayama. 2017; 71: 413-418
- Meniscal repair using the FasT-Fix all-inside meniscal repair device.Arthroscopy. 2005; 21: 167-175
- Prognostic factors for all-inside meniscal repair. A 87-case series.Orthop Traumatol Surg Res. 2017; 103: 1017-1020
- Arthroscopic all-inside meniscus repair using a new refixation device: A prospective study.Arthroscopy. 2002; 18: 387-393
- Results of all-inside meniscal repair with the FasT-Fix meniscal repair system.Arthroscopy. 2006; 22: 3-9
- Arthroscopic repair of horizontal meniscal cleavage tears with marrow-stimulating technique.Arthroscopy. 2015; 31: 92-98
- Meniscal repair with the RapidLoc meniscal repair device.Arthroscopy. 2006; 22: 962-966
- FasT-Fix meniscal repair: Mid-term results.Arthroscopy. 2008; 24: 1342-1348
- Small medial meniscocapsular separations: A potential cause of chronic medial-side knee pain.Arthroscopy. 2011; 27: 1536-1542
- All-inside suture device is superior to meniscal arrows in meniscal repair: A prospective randomized multicenter clinical trial with 2-year follow-up.Knee Surg Sports Traumatol Arthrosc. 2015; 23: 211-218
- The popliteus tendon provides a safe and reliable location for all-inside meniscal repair device placement.Knee Surg Sports Traumatol Arthrosc. 2018; 26: 3611-3619
- Long-term outcomes of all-inside meniscal repair.Knee Surg Sports Traumatol Arthrosc. 2015; 23: 219-224
- Comparative outcomes of all-inside versus inside-out repair of bucket-handle meniscal tears: A propensity-matched analysis.Orthop J Sports Med. 2018; 6 (2325967118779045)
- Prevalence, development, and factors associated with cyst formation after meniscal repair with the all-inside suture device.Arch Orthop Trauma Surg. 2019; 139: 1261-1268
- Meniscal tear repaired with Fast-Fix sutures: Clinical results in stable versus ACL-deficient knees.Arch Orthop Trauma Surg. 2012; 132: 349-356
- Results with all-inside meniscal suture in pediatrics.Orthop Traumatol Surg Res. 2016; 102: 207-211
- Repair of isolated horizontal meniscal tears with all-inside suture materials using the overlock method: Outcome study with a minimum 2-year follow-up.J Orthop Surg Res. 2016; 11: 131
- Long-term outcome after all inside meniscal repair using the FasT-Fix system.J Orthop. 2018; 15: 602-605
- Modern treatment of meniscal tears.EFORT Open Rev. 2018; 3: 260-268
- Inside-out versus all-inside repair of isolated meniscal tears: An updated systematic review.Am J Sports Med. 2017; 45: 234-242
- Rehabilitation and return to play following meniscal repair.Oper Tech Sports Med. 2017; 25: 194-207
- Factors predicting failure rates and patient-reported outcome measures after arthroscopic meniscal repair.Arthroscopy. 2019; 35: 3146-3164.e2
- Meniscus tears in the young athlete: Results of arthroscopic repair.J Pediatr Orthop. 2011; 31: 496-500
- Meniscal repair in the elite athlete: results of 45 repairs with a minimum 5-year follow-up.Am J Sports Med. 2009; 37: 1131-1134
- Rehabilitation and return to play following anterior cruciate ligament reconstruction.Oper Tech Sports Med. 2017; 25: 181-193
- Anterior cruciate ligament injuries in baseball players.Arthroscopy. 2016; 32: 2278-2284
Article info
Publication history
Published online: March 19, 2021
Accepted:
February 21,
2021
Received:
September 21,
2020
Footnotes
The authors report the following potential conflicts of interest or sources of funding: B.J.C. reports other from Aesculap, National Institutes of Health, and Operative Techniques in Sports Medicine; personal fees from OSSIO; personal fees and other from Regentis; other from Smith & Nephew; grants, personal fees, and other from Arthrex; and other from Elsevier Publishing, BandGrip, AccuMed, Encore Medical GE Healthcare, Merck Sharp & Dohme, Sportstek Medical, and Vericel, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2021 by the Arthroscopy Association of North America
