This protocol addresses old bucket-handle tears occurring alongside a concomitant anterior cruciate ligament (ACL) tear. Because isolated meniscus repair in an ACL-deficient knee carries a high failure rate, both pathologies ideally require surgical attention together. When that combined approach has already been attempted and the repair goal was not met, a defined next step applies.
This protocol is indicated after simultaneous arthroscopic meniscus repair and ACL reconstruction has been performed but meniscus healing was not achieved. The non-achievement of that healing target is the clinical trigger for escalating to this line of management.
When simultaneous repair has failed to achieve meniscus healing, a resective surgical option — specifically involving partial removal of the meniscus — becomes the relevant consideration. This approach is applied under particular circumstances and is not the first choice; the structured protocol specifies the criteria and conditions under which it is used.
DOI: 10.1007/s00167-020-05847-3
Isolated meniscus repairs in unstable knees, such as an ACL-deficient knee, should be avoided because of their high failure rate.
Ideally, both pathologies are addressed during the same surgery.
Partial meniscectomy of traumatic meniscus tears should only be applied if the other two treatment options are not applicable, e.g., in complex tears, tears with a high degree of degeneration, flap tears or nonreducible bucket handle tears.
View source ↗