2025 ISAKOS Biennial Congress ePoster
Failure And Complication Rates Following Meniscal All-Inside And Inside-Out Repairs: A Meta-Analysis
Juan Bernardo Villarreal-Espinosa, MD, Chicago, Illinois MEXICO
Rodrigo Saad Berreta, BA, Reading, PA UNITED STATES
Lucas Pallone, MD BRAZIL
Felicitas Allende Figueroa, MD, Córdoba ARGENTINA
Fernando Gómez Verdejo, MD, Mexico City, Mexico City MEXICO
Zeeshan Khan, BA, Chicago, IL UNITED STATES
Melissa Carpenter, MD, Chicago, Illinois UNITED STATES
Sachin Allahabadi, MD UNITED STATES
Jorge Chahla, MD, PhD, Hinsdale, IL UNITED STATES
Rush University Medical Center, Chicago, Illinois, UNITED STATES
FDA Status Not Applicable
Summary
The present study underscores comparable clinical success between AI and IO meniscal repair techniques, with both techniques demonstrating similar complication rates.
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Abstract
Purpose
To examine failure, complication rates, and patient reported outcome measures (PROMs) between meniscal all inside (AI) versus inside out (IO) repair techniques.
Methods
A systematic search was conducted on level I-III studies evaluating outcomes after meniscal repair. The primary outcome regarded differences in failure rates between AI and IO meniscal repair techniques. Secondary outcomes included a comparison of complication rates and PROMs between groups. Quality assessment was performed using the GRADE and MINORS criteria. A meta-analysis was conducted for outcomes reported by more than three comparative studies.
Results
A total of 24 studies (13 studies and 912 menisci for AI vs. 17 studies and 1,1117 menisci for IO) were included. The mean follow-up ranges were 22-192 months (AI) and 18.5-155 months (IO). The overall reported AI failure rate ranged from 5- 35% compared to 0- 25% within the IO group. When comparing meniscal repair failure rates in the specific setting of concomitant anterior cruciate ligament reconstruction, the AI group had a failure rate ranging from 5-34% versus 0-12.9% in the IO group. Complication rate ranged from 0-40% for AI and 0-20.5% for IO. Post-operative PROM scores ranged from 81.2-93.8 (AI) vs 89.6-94 (IO) for IKDC and 4.0-7.02 (AI) vs 4.0-8.0 (IO) for Tegner. Upon pooling of six comparative studies, a significantly lower failure rate favoring the inside-out technique was observed (15.9% AI vs. 11.1% IO; p=0.02), though this result was influenced by a study with a predominantly elite athlete population. Moreover, no significant differences were found regarding complication rates between cohorts (7.3% AI vs. 4.8% IO; p=0.86).
Conclusion
The present study underscores comparable clinical success between AI and IO meniscal repair techniques, with both techniques demonstrating similar complication rates. However, the IO repair technique was associated with lower odds of failure compared to the AI cohort.