All-inside repair of bucket handle meniscus tears - Mid-term outcomes with postoperative magnetic resonance imaging.

Purpose: The purpose of this study was to evaluate our results of bucket handle meniscus tear (BHMT) repairs with an all-inside repair technique using postoperative radiological imaging to evaluate meniscus reduction and healing and use them as criteria for evaluation of repair success.

Methods: Prospective recruitment of 20 patients with 21 BHMT repairs performed with an all-inside techniqueover a period from 2013 to 2015. All patients had an International Knee Documentation Committee (IKDC) Subjective Knee Form (SKF), Lysholm Score, Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner Activity Level Scale obtained pre-operatively and at a minimum of 24 months after surgery. All patients had postoperative knee magnetic resonance imaging (MRI) performed between 18 and 24 months after surgery to assess the stability or failure of their repairs.At 5 years after surgery, the patients were assessed with regard to whether they had undergone repeat surgery or not.

Results: At 2 years, the mean postoperative SKF, Lysholm and KOOS grand scores were 78.9, 88.5 and 86.8, respectively. The mean pre-injury Tegner Activity Scale was 7.6 and postoperatively it was 6.0. There was a significant difference in all pre- and postoperative outcome scores (P < 0.01). The postoperative MRIs showed that 19 of the 21 BHMT repairs had stable reduction of the tear fragment and two patients had displacement of the torn bucket handle fragment. At 5 years, one patient had undergone revision surgery.

Conclusion: BHMTs can be repaired with all-inside techniques with good results and successful outcomes.