Bucket Handle Meniscus Tear

2021 ◽  
Author(s):  
Gary Peiser
Keyword(s):  
2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0030
Author(s):  
Laura Keeling ◽  
Alexandra Galel ◽  
Cooper Ehlers ◽  
David Wang ◽  
Edward Chang

Objectives: Bucket handle meniscus tears often present concurrently with tears of the anterior cruciate ligament (ACL). However, little is known regarding the influence of demographic factors on surgical decision-making, or on outcomes following treatment of bucket handle meniscus tears in ACL-deficient patients. Furthermore, no study has compared outcomes in this population between patients undergoing meniscectomy versus repair. The purpose of this study was therefore to determine if there is a difference in outcomes between patients presenting with concomitant ACL and bucket handle meniscus tears treated with meniscal repair versus meniscectomy. A secondary aim of this study was to discover if there is an association between the decision to perform a meniscus repair or meniscectomy based on demographic factors. Methods: In this institutional review board-approved retrospective study, we evaluated 62 patients presenting with ACL tear who were found to have a bucket handle meniscus tear preoperatively or at the time of ACL reconstruction. Of those, 30 patients underwent partial meniscectomy, while 32 underwent meniscal repair. Primary outcome measures included ACL and meniscal retear rates, as well as patient-reported outcome measures (PROMs). Documented PROMs included the International Knee Documentation Committee (IKDC), Single Assessment Numeric Evaluation (SANE), and ACL-Return to Sport after Injury (ACL-RSI) scores. Demographic and patient-specific factors evaluated included age, body mass index (BMI), smoking status, and location of meniscus tear. Results: Of 62 patients presenting for ACL reconstruction with concomitant bucket handle meniscus tear, a total of 34 patients with greater than one year (mean 22.4 month) follow-up were included. 14 patients underwent repair, and 20 underwent meniscectomy. No significant differences were noted in IKDC (p = 0.36), delta IKDC (p = 0.18), SANE (p = 0.61), or ACL-RSI (p = 0.67) scores between the repair and meniscectomy groups at final follow-up. No significant differences were found in ACL (p = 1.00) or meniscus (p = 0.49) retear rates between the two groups. Younger age, lower BMI, and tear location (red-red zone) were significantly associated with the decision to perform meniscal repair over meniscectomy (p < 0.05). Conclusions: Among patients presenting with concomitant ACL and bucket handle meniscus tears, we found no difference in patient-reported outcomes or retear rates in patients undergoing meniscal repair versus meniscectomy. Demographic and patient-specific factors including age, BMI, and tear location may influence surgical decision-making when determining the optimal treatment of bucket handle meniscus tears in this population.


2008 ◽  
Vol 13 (6) ◽  
pp. 33-35
Author(s):  
Tricia Hubbard ◽  
Mark Rodger ◽  
Christopher Mazoue

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0020
Author(s):  
Lue-Yen Tucker ◽  
Amy Vieira ◽  
David Ding

Objectives: Comprising approximately 10% of all mensiscus tears, bucket-handle meniscus tears are large longitudinal vertical meniscus tears that have an attached fragment flipped into the intercondylar notch. Meniscectomy would often result in significant meniscal loss and increased joint loading. Alternatively, meniscus repair attempts to restore the function of the meniscus and aims to preserve joint mechanics. The objective of this observational data-only study is to evaluate the long-term risk of subsequent ipsilateral knee surgery in patients who underwent a bucket handle meniscus repair and assess risk factors associated with subsequent knee surgical intervention. Methods: We performed an electronic health records search for all patients who underwent arthroscopic knee meniscal repairs from 2011 to 2018. Natural language processing was used to search for terms of interest in the long operative notes to determine if these surgeries were performed for bucket handle meniscus tears. These patients comprised our initial cohort. Study subjects were followed for at least one year and up to five years with censoring at death, membership disenrollment, or 12/31/2019. Baseline patient characteristics and outcomes (i.e., subsequent operative procedures, deep surgical site infections, and deep venous thrombosis) were evaluated via a database review. Descriptive statistics were employed. Results: The median follow-up time was 4.2 years (interquartile range [IQR] 2.7-5.0 years). A total of 1353 patients underwent meniscus repair surgery for a bucket-handle meniscus tear. The median age was 24 years (IQR 17-34). During the follow-up period, 492 subsequent ipsilateral procedures were performed in 272 (20.1%) patients. 59 (4.3%) patients underwent a subsequent repeat meniscus repair and 164 (12.1%) patients underwent a subsequent meniscectomy. The median time to first procedure was 41.1 months (IQR 23.3-60 months). Younger age and lower BMI were significant risk factors for having subsequent surgery (adjusted odds ratio [aOR] 1.04, 95% Confidence Interval [95%CI] 1.02-1.05, and aOR 1.60, 95%CI 1.09-2.35, respectively). Patients undergoing concomitant ACL reconstruction had a lower risk of undergoing subsequent surgery (aOR 0.66, 95%CI 0.50-0.88). Conclusions: This is the largest reported contained patient cohort study on outcomes after bucket-handle meniscus repair. 20% of patients underwent repeat surgery during the follow-up time period with 4.3% experiencing a subsequent repeat meniscus repair and 12% experiencing a subsequent meniscectomy. Risk factors for subsequent surgery include younger age and lower BMI. Concomitant ACL reconstruction at time of bucket-handle meniscus repair reduced the risk of subsequent reoperation.


Author(s):  
U. Nivetha ◽  
. Vignesh ◽  
. Anvesh ◽  
. Munis ◽  
Navin Balasubramaniam

Objective: To assess the incidence, nature and pattern of meniscal tear in ACL injury. Methodology: A retrospective study was conducted among the patients who were admitted and treated for ACL tear in Saveetha Medical And College And Hospital over a 2-year period from August 2019-August 2021. There were 52 patients admitted and treated for the same. The case records of each of the patients were reviewed to find the incidence of meniscal lesion in ACL tear and were then analyzed using appropriate statistical tests. Results: 52 patients with ACL tear were reviewed in this study. ACL tear was most commonly reported in younger age group of 20-29 (46.15%). Out of which, 19(36.54%) patients had meniscal tears. About 9(47.37%) patients had lateral meniscus tear, 6(31.58%) had medial meniscus tear and 4(21.05%) had bilateral meniscal tear. It was seen that bucket handle injury (n=12) was the most common meniscus tear overall. Radial tear was most specifically common in bilateral meniscus injury (N=4). Conclusion: Meniscal tears are the most common intra articular lesions associated with ACL tear. It was most commonly reported in the age group of 20-29. We found that the incidence of lateral meniscal tear was significantly higher in the patients rather than medial meniscal tear. Bucket handle injury was the most commonly reported tear in meniscal injury. Therefore, the surgeon needs to equip himself with the necessary meniscal repair instruments in his armamentarium


2020 ◽  
Vol 27 (4) ◽  
pp. 451-453
Author(s):  
Tina Shiang ◽  
Hemang Kotecha

1988 ◽  
Vol 01 (03/04) ◽  
pp. 152-154
Author(s):  
S. Johnson ◽  
D. Hulse

degenerative changes of the involved stifle joint associated with a “bucket handle” tear of the caudal body of the lateral meniscus. Surgical excision of the torn section of meniscus was beneficial in the first patient but this patient had persistant difficulty with the leg after exercise. Gross and microscopic pathology of the involved stifle in the second patient showed the meniscal lesion to be associated with severe cartilage fibrillation of the overlying lateral femoral condyle. As in human beings, the mechanism of injury may have been placement of the foot during vigorous external rotation of the femur with the stifle flexed. Extension of the limb from this position could have resulted in an isolated tear of the lateral meniscus.


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