What Is a Bucket Handle Tear of the Meniscus?

Knee injuries limit mobility and cause discomfort. Understanding their specific nature is important for effective management and recovery. Among various knee injuries, certain tears are particularly disruptive due to their unique characteristics and impact on joint function.

Understanding the Meniscus

The knee joint contains two C-shaped pieces of cartilage known as menisci: the medial meniscus on the inner side and the lateral meniscus on the outer side. These structures are positioned between the thigh bone (femur) and the shin bone (tibia). The menisci absorb shock, distribute forces, contribute to knee stability, and aid in joint lubrication.

Defining a Bucket Handle Tear

A bucket handle tear is a longitudinal tear where a portion of the meniscus detaches but remains connected at both ends. This detached segment can then flip into the center of the knee joint, resembling the handle of a bucket. This tear can cause significant pain. Bucket handle tears occur more frequently in the medial meniscus.

Causes of These Tears

Bucket handle tears result from sudden twisting or pivoting motions of the knee. This happens when the foot is planted and the knee rapidly rotates. They are seen in athletes in sports involving quick changes in direction or forceful stops. While more common in younger individuals and athletes, these tears can also result from missteps, falls, or everyday activities, especially in older individuals with meniscus degeneration.

Common Symptoms

Individuals with a bucket handle tear experience immediate, severe knee pain. A popping sensation upon injury is also a reported symptom. Swelling and stiffness in the knee develop within days of injury. A distinctive symptom is knee catching or locking, meaning the knee cannot fully straighten from a bent position due to the displaced meniscal fragment. Other symptoms include instability or the knee giving way.

Diagnosis and Treatment

Diagnosis of a bucket handle tear begins with a physical examination of the knee, assessing range of motion and stability. An MRI (Magnetic Resonance Imaging) scan confirms the diagnosis and determines the tear’s precise location and type. X-rays may also rule out other bone issues, though they do not show meniscus tears.

Surgical arthroscopy is the recommended treatment for bucket handle tears. During this minimally invasive procedure, small incisions allow viewing inside the knee. The surgeon either repairs the torn meniscus by stitching fragments together or removes the damaged portion. Repair is preferred to preserve knee function and prevent future problems. Following surgery, rehabilitation involves physical therapy to restore knee strength, stability, and range of motion.

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