Optimization of Arthroscopic All-Inside Meniscus Repair With a Probe.

Abstract

Meniscal preservation is essential for knee function and long-term joint health. All-inside meniscus repair achieves outcomes comparable to the inside-out technique, but technical challenges remain, including limited working space, suture cut-out in degenerative tissue, unfavorable suture angles, and risk of cartilage injury or arthroscope entanglement. The arthroscopic probe is used to assess tear pattern, tissue quality, stability, and working space, guiding portal selection or alternative approaches. Twirling the suture along the probe allows controlled loop positioning and tightening. Two strategies are employed: (1) countering the pulling force with the probe directly on the loop and meniscus, and (2) staged tightening using a short working length when resistance, angulation, or limited space hinders suture pulling. These maneuvers provide tactile feedback, reduce suture loop displacement, and minimize cartilage injury. Probe-assisted techniques enhance control during loop positioning and incremental tightening, optimize tear margin apposition, and reduce risk of cut-out in complex or degenerative tears. Incorporating these strategies contributes to successful all-inside repair, maximizing meniscus preservation and overall surgical outcomes.