Outside-In Meniscus Repair Using a Bidirectional Device for Anterior Horn Tears and Its Applicability to Bucket-Handle Tears: A Technical Note.

The outside-in technique is widely preferred for anterior horn tears because of its direct access. However, conventional methods require manipulation of multiple instruments in a limited working space. We introduce a specialized needle with a bidirectional groove at its tip, allowing single-handed antegrade and retrograde suture passage. This simplifies the procedure and reduces operative time. The device is also applicable to bucket-handle tears via a hybrid approach that combines all-inside suture passage and outside-in retrieval, achieving fixation comparable with that of the inside-out technique.