A COMPARATIVE ANALYSIS OF FUNCTIONAL OUTCOMES BETWEEN INSIDE-OUT AND ALL-INSIDE ARTHROSCOPIC TECHNIQUES IN MENISCAL TEAR REPAIR

Abstract

\Introduction: Meniscal preservation has become the preferred treatment for repairable meniscal tears because of its role in maintaining knee biomechanics and preventing early osteoarthritis. Among the available techniques, inside-out and all inside arthroscopic repairs are widely used, but their comparative functional outcomes remain an area of interest. Aim: To compare the functional outcomes of inside-out and all-inside arthroscopic techniques for meniscal tear repair. Methodology: This prospective comparative study was conducted in the Department of Orthopaedics, Sree Balaji Medical College and Hospital, over 18 months. A total of 46 patients with repairable meniscal tears were enrolled and equally divided into two groups: inside-out repair (n=23) and all-inside repair (n=23). Patients underwent preoperative clinical and MRI evaluation followed by arthroscopic repair. Functional outcomes were assessed using the Lysholm Knee Score and International Knee Documentation Committee (IKDC) score, with follow-up at 3 and 6 months. Statistical analysis was performed using SPSS version 25, and a p-value <0.05 was considered significant. Results: Both groups showed significant postoperative improvement in functional outcomes. Good-to-excellent Lysholm scores were achieved in 89.1% of patients. The inside-out group demonstrated a slightly higher postoperative IKDC score (91.64 ± 4.74) than the all-inside group (88.75 ± 6.99). The all-inside technique required significantly less operative time (64.65 vs. 92.96 minutes) and fewer fixation devices. Complication rates were low, with no neurovascular injuries observed. Conclusion: Both inside-out and all-inside arthroscopic meniscal repair techniques provide excellent functional outcomes with low complication rates. The all-inside technique offers the advantages of shorter operative time and fewer fixation devices, whereas the inside-out technique remains an effective option for complex tears. The choice of technique should be individualized based on tear characteristics and surgeon expertise.