Medial meniscus posterior root tears (MMPRTs) can severely disrupt knee biomechanics, leading to changes similar to those observed after subtotal meniscectomy and increasing the risk of joint degeneration.A recent systematic review evaluated the available biomechanical and clinical evidence on all-inside repair (AR) for MMPRTs, comparing this technique with the traditional transtibial pull-out (TP) repair. Thirteen studies were included in the analysis.

The findings demonstrated that all-inside repair effectively restores knee contact mechanics and provides biomechanical strength comparable to transtibial repair. Furthermore, patients undergoing all-inside repair showed better outcomes than those receiving no repair, including a lower risk of progression to total knee arthroplasty.No significant differences in patient-reported outcomes were observed between all-inside and transtibial techniques, suggesting that both approaches can achieve satisfactory clinical results.

Overall, the current evidence supports all-inside repair as a reliable treatment option for selected patients with MMPRTs, offering favorable biomechanical performance and encouraging clinical outcomes.