Arthroscopic Treatment of a "Bucket-Handle Like Tear" Lesion of the Medial Meniscus

Abstract

Menisci are involved in providing shock absorption, knee stability, and load transfer. Age, tear pattern, location, size and extent, repair time and technique, and patient habits are among various factors that affect meniscal healing. Meniscus repair has become the procedure of choice for the treatment of meniscal tears. However, treatment of meniscal tears in patients over 40 years of age is still debatable. Rare patterns of lesions have been described in the literature. We report a zone 2, partial thickness, "bucket-handle like tear" medial meniscal lesion with two attached ends in a 48-year-old male patient with persistent symptoms after six months of conservative treatment. Arthroscopic excision and debridement were performed. At a six-month follow-up, the patient regained 90% of his functional capacity.

Keywords: arthroscopic resection; bucket handle tear; knee anatomy; meniscus surgery; surgical repair.

Figure 1. (A) MRI T2 coronal image shows partial-thickness rupture of zone 2 of the medial meniscus (red arrow). (B) MRI T1 sagittal consecutive images show the same rupture of zone 2 of the medial meniscus (red arrows).

Figure 2. Partial in two dimensions - length and height - “bucket-handle like tear” lesion. (A) In length (yellow arrows). (B) In height (red arrow).

Figure 3. Arthroscopic excision and debridement. (A) The distal end of “bucket-handle like tear” (red arrows). (B) The central flap of meniscal tear (red arrow). (C) After the excision of the free flap the remaining body of the meniscus was intact (yellow arrow).