Bucket-Handle Meniscus Tears: Epidemiology, Diagnosis, Management, and Outcomes

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Bucket-handle meniscus tears (BHMTs) are complex knee injuries.
• They often cause mechanical symptoms like locking and pain, particularly in active individuals and those with ACL injuries.
• Risk factors include meniscal morphology, ligamentous laxity, tibial slope, obesity, malalignment, and high-impact sports.

Purpose of the Study:

• To review the current understanding of BHMTs, including their causes, symptoms, and treatment options.
• To compare the efficacy of surgical repair versus nonoperative management.
• To discuss the importance of postoperative rehabilitation strategies.

Main Methods:

• Literature review of studies on bucket-handle meniscus tears.
• Analysis of surgical repair techniques (inside-out, all-inside) and nonoperative management.
• Evaluation of rehabilitation protocols and outcomes.

Main Results:

• Surgical repair is generally preferred for BHMTs, improving functional outcomes and potentially delaying osteoarthritis.
• Nonoperative treatment may be suitable for select low-demand or medically ineligible patients, but carries risks of accelerated osteoarthritis and instability.
• Postoperative rehabilitation protocols vary, impacting range of motion, strength, and return to sport.

Conclusions:

• While short- to mid-term outcomes for BHMT repair are promising, long-term data remain limited.
• Optimizing surgical techniques and standardizing rehabilitation protocols are crucial for enhancing long-term functional recovery and joint survivorship.
• Further research is needed to define the optimal long-term management strategies for BHMTs.