Bucket handle meniscus tear repair and treatment options

Bucket handle meniscus tear repair and treatment options

In this article, Ross Hauser, MD and Katherine L. Worsnick, MPAS, PA-C present information on the bucket handle meniscus tear sometimes overlooked in the doctor-patient consultation. Not all bucket handle meniscus tears need to be operated on. The reasons are presented below.

For many doctors and patients, arthroscopic repair is the treatment of choice for meniscal tears. Indeed in many cases, this is warranted. This article will discuss bucket handle tear surgery, realistic recovery expectations following an arthroscopic bucket handle procedure, and various non-surgical options.

Bucket handle meniscus tear surgery failure rates
23.5% to 34% confirmed by two different studies from surgeons

You go to the orthopedist. You have a bucket handle meniscus tear. A look at an MRI convinces the doctor to offer a recommendation to have suture repair surgery (the doctor will stitch up the tear) as opposed to meniscus tissue removal surgery. The doctor tells you that based on the research, the results from this type of procedure are satisfying. How satisfying? Let’s ask universities researchers in Germany who published these findings in the

In June 2018 German doctors at the University Medical Center Freiburg published these findings that they shared with orthopedic surgeons from around the world in the journal: Archives of Orthopaedic and Trauma Surgery:

How about a second opinion on this?

Doctors at the Department of Orthopaedic Surgery, Division of Sports Medicine , New York University Langone Medical Center, Hospital for Joint Diseases in New York have released a May 2017 study in which they  investigated the failure rate for surgically repaired bucket-handle meniscus tears and compared the numbers in those clinical outcomes of bucket handle meniscus repair failure versus those that did not fail at a minimum 2-year follow-up.

Is bucket handle meniscus tear surgery necessary for every patient?
The curious case of a 71-year-old patient that shows spontaneous healing is possible. Younger patients should pay attention.

Doctors at the Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine describe the case of a 71-year-old-patient with a bucket handle meniscus tear that healed spontaneously.

Here is what they wrote in the medical journal Geriatric Orthopaedic Surgery & Rehabilitation:

“Displaced bucket-handle meniscal tears are usually treated operatively. Due to the rarity of these tears in elderly patients and conflicting evidence regarding the use of arthroscopy versus conservative treatment, it is valuable to report the clinical presentation, treatment, and outcome of these injuries in elderly patients.”

So something curious is happening here, something that can affect not only elderly patients by bucket handle injury patients as well.

This case history involves a 71-year-old man with acute, displaced, MRI-confirmed right medial meniscus bucket-handle tear with mild effusion and no signs of degenerative joint disease.

(Displaced bucket handle meniscus tears mean the flap of the tear has moved away from the tear and is pointing forward into the knee. This leads to the characteristic symptoms of knee locking and inability to straighten the knee.)

This case suggests that in elderly patients with displaced medial meniscus bucket-handle tears that reduce spontaneously, the physician can safely and efficaciously use conservative, nonoperative management to achieve restoration of baseline knee function and anatomic meniscal healing while avoiding the risks of arthroscopic surgery.(3)

We know what the athletes out there are saying – that took 6 months! Yes, but 6 months is less time than 1/3rd of you having to go through a second meniscus surgery. However, there can be a way to speed up and help this spontaneous healing.

The evidence for Platelet Rich Plasma therapy and Prolotherapy for Meniscus Tears

One of the treatments we offer to help accelerate and augment non-surgical repair of meniscus injury in Platelet Rich Plasma Therapy combined with Prolotherapy. In the video below a general description and demonstration of the treatment is offered.

Writing in the Physical Medicine and Rehabilitation the journal of injury, function, and rehabilitation, Jessica Urzen of the University of Louisville and Brad Fullerton of the Texas A&M’s College of Medicine, reported of a case of a patient with a bucket handle meniscus tear that resolved non-surgically with Platelet Rich Plasma injections.

They report the case of “a 43-year-old man with magnetic resonance imaging-confirmed medial bucket handle meniscal tear who received 3 treatments of platelet-rich plasma injections in and around the meniscus within 7 months after the diagnosis of the tear. The patient reported resolution of pain with walking 8 months after the injury. Magnetic resonance imaging 10 months after the injury and arthroscopy 47 months after the injury showed complete resolution of the meniscal tear.”(4)

At this point, we are going to ask you to do one of two things. Continue on with your research at our companion articles on PRP and Prolotherapy for meniscus tears where we will explore research on Platelet Rich Plasma therapy for meniscus injury. This is an especially good article is for people exploring the possibility of meniscus arthroscopic surgery, meniscus arthroscopic surgery with PRP augmentation, or PRP injections for meniscus tears as an option. See Platelet rich plasma injections for meniscus tears.

Or if you would like to explore these treatments, ask us your questions.

Prolotherapy Specialists Bucket handle meniscus tear repair and treatment options

If you have questions about bucket handle meniscus tear repair and treatment options, get help and information from Caring Medical

1 Hupperich A, Salzmann GM, Niemeyer P, Feucht M, Eberbach H, Südkamp NP, Kühle J. What are the factors to affect outcome and healing of meniscus bucket handle tears?. Archives of orthopaedic and trauma surgery. 2018 Jun 29:1-9. [Google Scholar]

2 Moses MJ, Wang DE, Weinberg M, Strauss EJ. Clinical outcomes following surgically repaired bucket-handle meniscus tears. The Physician and Sportsmedicine. 2017 Jul 3. [Google Scholar]

3. Ciminero ML, Huntley SR, Ghasem AD, Pitcher JD. Self-reduction of displaced bucket-handle medial meniscal tear in a 71-year-old patient: A case report. Geriatric orthopaedic surgery & rehabilitation. 2015 Dec;6(4):334-7.  [Google Scholar]

4. Urzen JM, Fullerton BD. Nonsurgical Resolution of a Bucket Handle Meniscal Tear: A Case Report. PM&R. 2016 Nov 30;8(11):1115-8. [Pubmed] [Google Scholar]

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