Inside-out Technique using the Suture Gripping Technique Enabling Withdrawal of Suture from Outside the Joint with a Suture Shuttle for Meniscal Suturing.

Abstract

Various meniscal repair techniques, including all-inside, outside-in, and inside-out methods, have been developed; however, they require complex maneuvers with each method, and there are limitations to the suture material. This report presents an arthroscopic inside-out technique for meniscal repair using a suture-gripping method with a suture shuttle, which allows insertion of the needle into the meniscus from inside the knee and withdrawal of the suture from outside the knee. This technique allows free gripping of the suture, making it possible for the suture to pass more accurately than with the standard outside-in technique, and enables a more flexible meniscal repair than that achieved with the standard inside-out technique. This technique overcomes the limitations of other techniques and offers flexibility in suture materials and methods. Furthermore, this technique is effective for suturing the anterior portion of the meniscus because the suture shuttle is more compact and flexible than the devices used in other techniques. This article aims to describe the benefits of this technique for suturing meniscal tears in a more flexible, straightforward, and minimally invasive manner.