Arthroscopic meniscus repair with suture: Inside-out with fibrin clot

The medial and lateral menisci serve the functions of load bearing, shock absorption, and joint stability among others. Meniscectomy has led to osteoarthritis changes in the knee leading most surgeon and researchers to develop techniques of meniscal repair. This has evolved into different arthroscopically assisted meniscal repair techniques, including the inside-out repair. The arthroscopic inside-out technique can be used to repair appropriate tears using standard arthroscopic portals and either a medial or lateral posterior incision for suture retrieval, to avoid neurovascular injuries. Arthroscopic cannulas are used to direct permanent sutures across the tear site and out the posterior incisions where they are tied directly over the capsule. Those tears with marginal healing potential may be augmented with a fibrin clot placed at the tear site using the inside-out technique. Fibrin clot delivers cytokines and healing factors directly to the repair site. Many series have documented the success of inside-out meniscal repair and the benefits of fibrin clot augmentation.