NIU Xingyue , ZHAO Qian , ZHENG Huifeng , CHEN Xiao , ZHAO Dong , WU Jiang , REN Fuji , HUANG Jingmin
  • Department of Sports Medicine and Arthroscopy Surgery, Tianjin Hospital, Tianjin, 300211, P. R. China;
HUANG Jingmin, Email: huangjingmin@126.com
Bucket-handle meniscal tear; meniscus suture; meniscoplasty; Inside-out technique; All-inside technique
10.7507/1002-1892.202308001
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective  To summarize the clinical features, surgical methods, and prognosis of bucket-handle meniscal tears (BHMTs), and provide guidance for clinical treatment. Methods  The clinical data of 91 BHMTs patients (91 knees), who met the selection criteria and were admitted between January 2015 and January 2021, was retrospectively analyzed. There were 68 males and 23 females. Age ranged from 16 to 58 years with an average of 34.4 years. The injury was caused by sports in 68 cases, traffic accident in 15 cases, and falls or sprains in 8 cases. There were 49 cases of left knee injury and 42 cases of right knee injury. The time from the onset of symptoms to the admission ranged from 1 day to 13 months (median, 18 days), including >1 month in 35 cases and ≤1 month in 56 cases. Medial BHMTs occurred in 52 cases and lateral BHMTs in 39 cases. There were 36 cases with ACL rupture and 12 cases with discoid meniscus. The knee extension was limited more than 10° in 55 cases. According to the condition of meniscus injury, the meniscus suture with Inside-out combined with All-inside techniques (54 cases) or meniscoplasty (37 cases) under arthroscopy were selected. ACL reconstruction was performed in all patients with ACL rupture with autogenous hamstring tendon. Postoperative complications were observed. International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score were used to evaluate knee function, and clinical failure was recorded. Results  Two patients developed intermuscular venous thrombosis, which improved after oral anticoagulant therapy. No vascular injury, postoperative infection, joint stiffness, or other complications occurred in all patients. All patients were followed up 24-95 months, with a median of 64 months. A total of 12 cases (13.19%) failed the operation and were re-operated or given oral anti-inflammatory analgesics and rehabilitation therapy. At last follow-up, IKDC score and Lysholm score of 91 patients significantly increased when compared with those before operation (P<0.05), while Tegner score significantly decreased (P<0.05). The above indexes of patients treated with meniscus suture and meniscoplasty were also significantly different from those before operation (P<0.05). Conclusion BHMTs occurs mostly in young men and is one of the important reasons for the limitation of knee extension after trauma. Arthroscopic meniscus suture and meniscoplasty can obtain good effectiveness according to individual conditions of patients. But the latter can better preserve the shape and function of meniscus, and theoretically can obtain better long-term outcomes, which needs to be confirmed by further research with larger sample size.

Citation： NIU Xingyue, ZHAO Qian, ZHENG Huifeng, CHEN Xiao, ZHAO Dong, WU Jiang, REN Fuji, HUANG Jingmin. Study on clinical characteristics and surgical methods of bucket-handle meniscal tears. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(11): 1335-1341. doi: 10.7507/1002-1892.202308001 Copy

  • Previous Article

    A multicenter randomized controlled trial of domestic robot-assisted and conventional total knee arthroplasty

  • Next Article

    Treatment of tibial insertion avulsion fracture of anterior cruciate ligament involving anterior root of lateral meniscus with multi-point fixation with anchor and suture