Journal article
All-Inside Versus Inside-Out Meniscal Repair With Concurrent Anterior Cruciate Ligament Reconstruction: A Meta-regression Analysis
The American journal of sports medicine, Vol.45(3), pp.719-724
03/2017
DOI: 10.1177/0363546516642220
PMID: 27159291
Abstract
Meniscal tears are frequently repaired during anterior cruciate ligament reconstruction (ACLR).
To systematically evaluate differences in clinical failures between all-inside and inside-out meniscal repairs performed during ACLR.
Meta-analysis; Level of evidence, 4.
A systematic review was perfomed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases queried included MEDLINE, CINAHL, EMBASE, and Cochrane Central Register of Controlled Trials. All English-language studies reporting failure rates after meniscal repair with either the all-inside or inside-out technique performed in conjunction with ACLR were identified between 1980 and 2015. Studies with a minimum 2-year follow-up were included. Reported outcomes, clinical meniscal repair failures, and complications were assessed. Studies were weighted according to the size of the clinical series and mean follow-up length. Inverse-variance-weighted mixed models were used to evaluate whether there was a significant difference in pooled reoperation rates between repair techniques.
In total, 21 studies met inclusion criteria. Of these, 13 studies reported outcomes after all-inside repair, and 10 studies reported outcomes after inside-out repair (2 studies reported both). A total of 1126 patients were included in the analysis. The mean (±SD) follow-up for all-inside repair was 58.64 ± 22.24 months versus 76.25 ± 31.69 months for inside-out repair ( P = .13). The clinical failure rate for all-inside meniscal repair performed concurrently with ACLR was 16% (121/744) compared with 10% (39/382) for inside-out repair, and this was found to be significant ( P = .016). Implant irritation and device migration were the most common complications reported for all-inside repair; complication rates did not differ between the groups.
There may be fewer early clinical failures when the inside-out technique is utilized for meniscal repair at the time of concomitant ACLR. Additional long-term studies will be useful to determine the operative success of these repairs over time.
Details
- Title: Subtitle
- All-Inside Versus Inside-Out Meniscal Repair With Concurrent Anterior Cruciate Ligament Reconstruction: A Meta-regression Analysis
- Creators
- Robert W Westermann - University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAKyle R Duchman - University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAAnnunziato Amendola - University of Iowa Hospitals and Clinics, Iowa City, Iowa, USANatalie Glass - University of Iowa Hospitals and Clinics, Iowa City, Iowa, USABrian R Wolf - University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- The American journal of sports medicine, Vol.45(3), pp.719-724
- Publisher
- United States
- DOI
- 10.1177/0363546516642220
- PMID
- 27159291
- ISSN
- 0363-5465
- eISSN
- 1552-3365
- Language
- English
- Date published
- 03/2017
- Academic Unit
- Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science; Athletic Training Program
- Record Identifier
- 9984040274902771
Metrics
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