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Bucket Handle, Inside-Out Medial Meniscal Repair: A Technique Video.

Camden Bohn¹, Matthew Varano¹, Henry Eilen¹

¹Rush University Medical Center, Chicago, Illinois, USA.

Video Journal of Sports Medicine

|April 27, 2026

Summary

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This study details the inside-out technique for repairing bucket-handle medial meniscal tears in athletes. The procedure, combined with femoral notch microfracture, aims for successful return to sports and symptom resolution.

Area of Science:

Orthopedic Surgery
Sports Medicine
Arthroscopy

Background:

Bucket-handle medial meniscal tears are common injuries in young athletes.
The inside-out technique is the established gold standard for operative medial meniscal repair.

Purpose of the Study:

To present a technique video for repairing bucket-handle medial meniscal tears in a young athlete.
To highlight pearls and pitfalls for maximizing success with the inside-out technique.

Main Methods:

Diagnostic arthroscopy to confirm the bucket-handle medial meniscal injury.
Reduction, debridement, and repair using an inside-out technique with a mechanized suture passer.
Performance of a femoral notch microfracture procedure post-repair.

Keywords:

arthroscopic meniscal repair bucket-handle tear inside-out mechanized suture passer medial meniscus

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Main Results:

The patient was expected to recover within 4-6 months, achieving return to sports and full recovery.
Surgical intervention aimed for symptom resolution, improved function, and high patient satisfaction.

Conclusions:

Accurate assessment of meniscal injury extent and consideration of meniscal regenerative capacity are crucial.
Mechanized suture passers and arthroscopic knot pushers can enhance surgical efficiency.
Femoral notch microfracture promotes a favorable healing environment by introducing marrow elements.