Abstract
Objectives
To compare patient-reported outcomes (PROs), failure, and healing rates following all-inside (AI) repair versus inside-out (IO) repair for the treatment of meniscal radial tears.
Methods
A literature search was performed according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the Scopus, PubMed, and Embase computerized databases. Level of evidence I through IV human clinical studies evaluating PROs and/or the incidence of failure and healing following AI versus IO repairs for meniscal radial tears were included. Study quality was assessed using the MINORS criteria and MCMS score.
Results
Ten studies comprising 205 patients were identified including 142 patients who underwent AI repair and 63 patients who underwent IO radial repair. Postoperative Lysholm and Tegner scores ranged from 90.8 to 95.6 and 5.7 to 8.2, respectively, in the AI repair group, compared to 86.9 to 94.2 and 6 to 7.5, respectively, in the IO repair group. Clinical failure ranged from 0% to 21.4% % and 0% to 62.5% in the AI and IO groups, respectively. Healing assessments on second-look arthroscopy revealed failure rates ranging from 0% to 8% in the AI repair group and 0% to 30% in the IO group. Complete and partial healing ranged from 13% to 69% in the AI group and from 22% to 58.3% in the IO group. Postoperative complications ranged from 0%-2% within the AI group compared to the IO group ranging from 0% to 25%. No implant-related complications were reported in any study group.
Conclusion
All-inside and inside-out repairs for meniscal radial tears both demonstrate improved PROs; however, current literature suggests that the IO technique may present higher failure and complication rates relative to AI repair techniques.