Purpose: To define MR signs of meniscal bucket-handle tears and evaluate the diagnostic efficiency of this technique.
Materials And Methods: Retrospective study of 30 patients with a meniscal bucket-handle tear and 30 with a different type of tear, all proven by arthroscopy. The following MR signs of a bucket-handle tear were evaluated: "separate meniscal fragment", "double posterior cruciate ligament", "snake sign" and "double anterior hom".
Results: A correct diagnosis of a bucket-handle tear was only made in 18/30 of patients. Several of the MR signs were seen in the same patient in 17 cases. A double posterior cruciate ligament was present only in cases of medial meniscus tears. The 12 menisci without these signs, and therefore not diagnosed as bucket-handle tears, were all classified as meniscal tears on the basis of signal extending to the meniscal surface. Nine of these were not displaced into the intercondylar notch at arthroscopy. The interobserver agreement was excellent: kappa = 0.88.
Conclusion: The diagnosis of a bucket-handle meniscal tear, if it is displaced, can be made when one or more of the four MR evaluated signs are present. Other forms of meniscal tears are only exceptionally diagnosed as bucket-handle tears.
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Jt Dis Relat Surg
January 2025
İstanbul Medeniyet Üniversitesi Göztepe Prof. Dr. Süleyman Yalçın Şehir Hastanesi, Ortopedi ve Travmatoloji Kliniği, 34722 Kadıköy, İstanbul, Türkiye.
This case report highlights a rare complication of arthroscopic meniscal tear which is an arteriovenous fistula and pseudoaneurysm of the superior medial geniculate artery. A 14-year-old male patient presented with persistent hemarthrosis following arthroscopic repair of a bucket handle medial meniscal tear. The patient was investigated due to suspicion of vascular damage.
View Article and Find Full Text PDFOrthop J Sports Med
December 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Background: Bucket-handle meniscal tears (BHMTs) are a common subtype of meniscal tears that represent a clinical challenge. Arthroscopic inside-out repair has been considered the gold standard in treatment; however, an all-inside approach has gained widespread popularity, with limited long-term evidence.
Purpose/hypothesis: The purpose of this study was to (1) compare long-term clinical outcomes and rates of failure after surgical repair of BHMTs using the all-inside versus inside-out technique, and 2) identify risk factors for failure at long-term follow-up.
Over the past 15 years, there has been a shift toward meniscus preservation even for previously believed irreparable patterns like bucket handle, radial, meniscus root, vertical, and horizontal cleavage tears (HCTs). HCTs are a common tear pattern, especially as we age, and are estimated to occur in 23% to 32% of meniscus tears. They occur in both males and females, are more common on the medial than the lateral side, and most often occur with minor to normal trauma in an anterior cruciate ligament intact knee.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
October 2024
Guy's and St Thomas' NHS Foundation Trust, London, UK.
Purpose: The prevalence and appreciation of meniscal tears in children have increased in both number and complexity. There is currently a paucity of high-quality evidence that can guide surgeons in treating skeletally immature patients with meniscal injuries. The aim of this study was to develop comprehensive recommendations for the management of isolated meniscal tears in skeletally immature children.
View Article and Find Full Text PDFOrthop J Sports Med
September 2024
Department of Orthopedic Surgery, Kaiser Permanente Orange County Medical Center, Anaheim, California, USA.
Background: Bucket-handle meniscal tears are large longitudinal vertical meniscal tears that have an attached fragment flipped into the intercondylar notch. Meniscal repair attempts to restore the function of the meniscus and aims to preserve joint mechanics. Alternatively, meniscectomy results in quicker recovery but may lead to future degeneration.
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