title: Arthroscopic Meniscal Repair: "Modified Outside-In Technique".
abstract: BACKGROUND
  Despite the introduction of different techniques for meniscal repair, no single procedure is superior in all situations. The new method for meniscal repair named "modified outside-in technique" aims to achieve higher primary fixation strength by an alternative suture technique as well as avoid disadvantages of outside-in, inside-out, and all-inside suture procedures. Additionally, the mid-term results of surgically treated patients with meniscal injuries by our new technique were evaluated.
  
  
  METHODS
  The current prospective study included 66 patients who underwent meniscal repair by the modified outside-in technique. The International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form was completed pre- and post-operatively. At final follow-up, Lysholm score was completed and patients were questioned about their return to previous sport activities. Clinical success was defined as lack of swelling and joint line tenderness, absence of locking, negative McMurray test and no need for meniscectomy. Patients' satisfaction was evaluated using the visual analogue scale (VAS). Patients were followed for 26±1.7 months.
  
  
  RESULTS
  Clinical success was achieved in 61 patients (92.4%) and 5 candidates required meniscectomy (7.6%). IKDC Subjective Knee Evaluation Form score increased significantly from 54.2±12.7 preoperatively to 90.8±15.6 postoperatively (P<0.001). Lysholm score was excellent and good in 49 (80.3%) patients and fair in 12 (19.7%). Patients' satisfaction averaged at 8.35±1 (6-10). Neurovascular injury, synovitis and other knot-related complications were not reported.
  
  
  CONCLUSIONS
  The modified outside-in technique has satisfactory functional and clinical outcomes. We believe that this procedure is associated with better clinical and biomechanical results; however, complementary studies should be performed to draw a firm conclusion in this regard.
authors.affiliation: Sohrab Keyhani MD Mohammad Reza Abbasian MD Nasim Siatiri MD Ali Sarvi MD Ali Akbar Esmailiejah MD Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of medical sciences, Tehran, Iran.
authors.forename: Sohrab
authors.initials: S
authors.lastname: Keyhani
authors.affiliation: Sohrab Keyhani MD Mohammad Reza Abbasian MD Nasim Siatiri MD Ali Sarvi MD Ali Akbar Esmailiejah MD Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of medical sciences, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Abbasian
authors.affiliation: Sohrab Keyhani MD Mohammad Reza Abbasian MD Nasim Siatiri MD Ali Sarvi MD Ali Akbar Esmailiejah MD Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of medical sciences, Tehran, Iran.
authors.forename: Nasim
authors.initials: N
authors.lastname: Siatiri
authors.affiliation: Sohrab Keyhani MD Mohammad Reza Abbasian MD Nasim Siatiri MD Ali Sarvi MD Ali Akbar Esmailiejah MD Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of medical sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Sarvi
authors.affiliation: Sohrab Keyhani MD Mohammad Reza Abbasian MD Nasim Siatiri MD Ali Sarvi MD Ali Akbar Esmailiejah MD Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of medical sciences, Tehran, Iran.
authors.forename: Mohsen Mardani
authors.initials: MM
authors.lastname: Kivi
authors.affiliation: Sohrab Keyhani MD Mohammad Reza Abbasian MD Nasim Siatiri MD Ali Sarvi MD Ali Akbar Esmailiejah MD Department of Orthopedic Surgery, Akhtar Hospital, Shahid Beheshti University of medical sciences, Tehran, Iran.
authors.forename: Ali Akbar
authors.initials: AA
authors.lastname: Esmailiejah
keywords: Arthroscopy; Meniscus; Modified outside-in technique