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Mix all the meatball ingredients in a large bowl to combine. You may need to use your hands to really get in there and mix it well. Once the meat is combined, store it in the fridge until ready to use.
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Bring a pot of water to a simmer and season heavily with salt. Add the pasta and cook about 7-8 minutes- about 3/4 of the amount of time it says on the package. It should be still crunchy but only a little.
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Reserve 1 cup of the pasta cooking liquid, then strain the pasta.
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Fill a piping bag with the meatball mixture. Only put in an amount that will be manageable, if you overfill it, it will be hard to push into the pasta.
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One by one, pipe the meatball mixture into the pasta. Really fill it up so it is bursting out of the edges of both sides of the pasta.
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Put a large heavy bottom pan over medium high heat and add in the butter and garlic. Cook 2 minutes until simmering. Add in the red pepper flakes. Then add in the pasta and gently stir to combine.
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Add in the wine, then the pasta cooking liquid. Only add enough of the pasta water to just barely cover the noodles. Bring to a simmer and cook about 10 minutes, adding more water if needed as the water evaporates.
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When the pasta is tender and the meat is cooked through, allow the water to reduce to only about half way up the pasta. Remove from heat and add in the parsley and parmesan. Stir to combine and thicken the sauce. Serve.
