All-inside devices eliminate accessory posterior incisions. A 2021 systematic review reported shorter surgical timeand lower risk of nerve damage with all-inside repair, while healing rates were similar to inside-out techniques.
Meniscal preservation reduces long-term cartilage degeneration compared with meniscectomy. Athletes undergoing repair have high return-to-play rates (~83%), typically within 8–9 months.
Comparative cadaveric studies show biomechanical differences between all-suture devices and PEEK-based implants. Some newer devices demonstrate lower load-to-failure values, highlighting the importance of selecting the right device for each tear type.
Bucket-handle tears: Both all-inside and inside-out achieve significant clinical improvement; outcomes vary widely depending on technique and rehabilitation.
Radial and root tears: Often require combined suturing strategies (all-inside + inside-out) to restore joint biomechanics.
All-inside repairs reduce the risk of nerve injury but may present early failures depending on case complexity. Risk factors include tear type, concomitant ACL reconstruction, and rehabilitation protocols.
Most patients experience faster recovery compared with open procedures. Return to sport is achievable in the majority of cases, although timelines vary from a few weeks to several months.
Meniscus repair devices significantly contribute to the principles of minimally invasive surgery: reduced tissue trauma, safer complication profile, and reliable functional outcomes. While evidence supports the efficiency and safetyof all-inside devices, device-specific biomechanical differences and patient selection remain decisive.
