Arthroscopic repair of bucket-handle tears of the lateral meniscus

Abstract

This study was undertaken to document the clinical results of arthroscopic meniscus repair for treatment of displaced bucket-handle tears of the lateral meniscus. From 2002 to 2010, 13 patients with symptomatic displaced bucket-handle tears of the lateral meniscus treated by arthroscopic meniscus repair were included in this study. Inclusion criteria were (1) displaced bucket-handle tear of the lateral meniscus demonstrated on magnetic resonance imaging, (2) non-discoid lateral meniscus, (3) stable knee, and (4) tears involving the red-white or red-red zone. Median age at operation was 20 years (range 14-54 years), and the median follow-up period was 4.0 years (range 2-10.7 years). All tears were repaired with either a modified all-inside suture technique only or a combination of the modified all-inside suture and modified outside-in techniques. Clinical results were evaluated preoperatively and at the final follow-up using Tegner activity level, Lysholm knee, and Hospital for Special Surgery (HSS) scores. All patients returned to their prior life activities with little or no limitations, and no reoperations were required during the follow-up period. On the final follow-up, all knees achieved full range of motion, except two knees with limited function during squatting and jumping due to pain. No patient had recurrence of a knee-locking episode. The median Tegner activity level improved significantly from 3 (2-6) to 7 (4-9) (p < 0.0001), mean Lysholm knee score improved from 78.5 ± 10.7 preoperatively to 94.6 ± 5.4 (p < 0.0001), and mean preoperative HSS score improved from 80.3 ± 8.5 to 95.9 ± 4.2 (p < 0.0001) during the follow-up period. Arthroscopic meniscus repair using the modified all-inside suture and modified outside-in techniques showed excellent clinical outcomes for treatment of symptomatic displaced bucket-handle tears of the lateral meniscus and were free of any complications or episodes of recurrence. Case series, Level IV.