Old bucket-handle tear
ICD-10 M23.2 · ICD-11 FA33.2

Treatment of Old Bucket-Handle Tear: Nonreducible Meniscus Tear with Intact ACL

This protocol addresses an old bucket-handle meniscus tear that is nonreducible, occurring in a patient with a stable knee and intact anterior cruciate ligament. The combination of chronicity and inability to reduce the tear defines the specific surgical decision-making context for this presentation.

A nonreducible bucket-handle tear represents a distinct challenge among meniscal injuries. Standard repair options may not be applicable in such cases — including complex tear morphology and situations where reduction is not achievable. The stability of the knee (intact ligaments, no ACL involvement) is a key factor that informs the treatment pathway for this scenario.

The structured protocol for this scenario involves a partial meniscus replacement approach — a surgical option considered when other meniscal interventions are not applicable or have not succeeded.

The complete regimen, surgical indications, and decision algorithm are available in the full protocol below.
Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1007/s00167-020-05847-3

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.

In the current study, a stable knee has intact ligaments.

Partial meniscus replacement may be considered for patients with failed meniscus surgeries and meniscus-related complaints.

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