A Simple Method of Meniscus Repair Using the Arthroscopic Outside-In Technique

We describe a simple method of arthroscopic outside-in meniscus repair that is easy to perform using readily available materials. The technique uses a 19-gauge venepuncture needle, a 16-gauge epidural needle, a No. 3 Prolene suture as a lasso loop, and No. 2 polydioxanone (PDS) sutures for meniscus repair. The venepuncture needle is used to puncture the meniscus from outside-in to deliver the Prolene lasso loop suture. The epidural needle is used to deliver one end of the PDS repair suture through the lasso loop. This suture end is captured by tightening the lasso loop, and delivered out of the joint by withdrawing the venepuncture needle. The epidural needle is kept in the joint. A second pass is made with the venepuncture needle at an appropriate site on the meniscus, and the lasso loop delivered. The other free end of the repair suture is threaded through the epidural needle and through the lasso loop. This other repair suture end is similarly captured and delivered out of the joint. The repair is completed by pulling on the free ends of the repair suture to apply it across the meniscus tear site, and secured by tying the suture to the capsule through a small incision.