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Inside-Out Meniscus Repair
Dr. James Chen, M.D. - In San Francisco, CA



Dr. Chen’s surgical technique for inside-out meniscus repair:


An arthroscopic-assisted surgical procedure performed to repair meniscus tears. Two small incisions are made on the front of the knee. An arthroscopic camera and instruments are used to identify the tear and ensure it is amenable to repair. A third, larger incision is made on the same side of the knee as the torn meniscus and the joint capsule is exposed. Sutures are passed through the meniscus on long needles from the inside of the knee and retrieved through the larger incision. The sutures are tied on the outside of the capsule while the meniscus is visualised through the arthroscope, ensuring the defect is properly closed.


Dr. Chen’s presentation on bucket handle meniscus tears:

Common Questions about Inside-Out Meniscus Repair

What is meniscus repair?

Meniscus repair is the sewing together of torn meniscal tissue.

When should a meniscus tear be repaired?

In a young patient when the tear is in a simple configuration (a uni-directional tear), is acute, and is in the more vascular red-white or red-red zones of the knee it should be repaired. If it is a complex tear (multi-directional, degenerative tear, flap tear, or tear in the white non-vascular zone then it should be removed and not repaired.

How is Inside-Out meniscus repair performed?

Inside-out meniscus repair is performed arthroscopically by placing sutures inside the knee to repair the mensicus. The sutures are tied down to the knee capsule outside of the knee through an accessory incision. Inside-out meniscus repair is the strongest meniscus repair and is still the gold standard for large tears.

Who is the best candidate for Inside-Out meniscus repair?

The ideal candidate is a patient with a large bucket handle meniscus tear in the red-red or red-white zone that is flipped into the notch. The inside-out meniscus repair is robust and allows for healing in the red-red zone of the knee.

What is the recovery after Inside-Out meniscus repair?

After surgery the patient is non-weightbearing with the use of crutches for 4 weeks. Physical therapy is prescribed for 8 weeks before return to full activity.

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