What Is the Treatment for an Old Bucket-Handle Meniscal Tear?
A bucket-handle tear is an unstable longitudinal meniscal tear. In the chronic ("old") presentation, the clinical priority is meniscal preservation — repair rather than resection — whenever technically feasible.
Even with a delayed presentation, repair of a chronic bucket-handle tear can yield good to excellent results. The target of treatment is meniscus healing, assessed by restoring the structural continuity of the torn meniscus.
Treatment approach
The recommended first-line intervention is an arthroscopic procedure directed at repairing the meniscus. The complete structured regimen — covering the full decision pathway, technique, and post-repair targets — is available via the link below.
References
DOI: 10.1007/s00167-020-05847-3
- Preservation of the meniscus is the first-line option because the clinical and radiological long-term outcomes are worse after partial meniscectomy than meniscus repair.
- Thus, repair is recommended for medial meniscus tears, unstable tears, such as bucket handle and double longitudinal tears, and isolated meniscus tears.
- However, repaired chronic meniscus tears achieve good to excellent results and thus should be repaired, when indicated, instead of partially resected.
- This recommendation also includes late repairs, if technically reasonable, because healing rates are still very good, even for late repairs.
- A repair that is completed as early as possible appears to produce a better clinical outcome, including a decreased failure rate.
- The most reliable technique to assess meniscus healing is arthroscopy.
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