A novel technique for arthroscopic reduction and repair of a bucket-handle meniscal tear

Abstract

We present a new technique designed for the reduction and repair of bucket-handle meniscal tears. After assessing the rotation of the displaced tear fragment of the meniscus, the centrally displaced portion of the tear is vertically pierced with a suture hook enabling passage of a No. 0 PDS suture, both limbs of which are retrieved out of the joint. Next, using a spinal needle and a shuttle relay system, both ends of the No. 0 PDS on the femoral and tibial surfaces of the meniscus are extricated outside the joint capsule. In the final step, reduction of the displaced fragment is achieved by pulling on the PDS suture and the same suture is used for repair too, after which additional sutures are applied. This is a useful technique, which affords the benefit of rotational reduction of a bucket-handle meniscal tear using a single suture, as well as improved maneuverability for freshening of the tear margins prior to repair and additional suturing, and finally for repair as a full-thickness vertical suture.

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References

  1. 1.

    Bender B, Shabat S, Mann G, Oz H, Adar E (2002) The double-loop technique for meniscal suture. Arthroscopy 18:944–947. doi:10.1053/jars.2002.32327

    PubMed  Google Scholar 

  2. 2.

    Cargill AO, Jackson JP (1976) Bucket-handle tear of the medial meniscus: a case for conservative surgery. J Bone Joint Surg Am 58:248–251

    CAS  PubMed  Google Scholar 

  3. 3.

    Dandy DJ (1990) The arthroscopic anatomy of symptomatic meniscal lesions. J Bone Joint Surg Br 72:628–633

    CAS  PubMed  Google Scholar 

  4. 4.

    Fisher SR, Markel DC, Koman JD, Atkinson TS (2002) Pull-out and shear failure strengths of arthroscopic meniscal repair systems. Knee Surg Sports Traumatol Arthrosc 10:294–299

    PubMed  Google Scholar 

  5. 5.

    Magee TH, Hinson GW (1998) MRI of meniscal bucket-handle tears. Skeletal Radiol 27:495–499. doi:10.1007/s002560050426

    Article  CAS  PubMed  Google Scholar 

  6. 6.

    Miura H, Kawamura H, Arima J, Mawatari T, Nagamine R, Urabe K, Iwamoto Y (1999) A new, all-inside technique for meniscus repair. Arthroscopy 15:453–455. doi:10.1016/S0749-8063(99)70066-6

    CAS  PubMed  Google Scholar 

  7. 7.

    Rimmer MG, Nawana NS, Keene GC, Pearcy MJ (1995) Failure strengths of different meniscal suturing techniques. Arthroscopy 11:146–150. doi:10.1016/0749-8063(95)90059-4

    CAS  PubMed  Article  Google Scholar 

  8. 8.

    Rodeo SA (2000) Arthroscopic meniscal repair with use of the outside-in technique. Instr Course Lect 49:195–206

    CAS  PubMed  Google Scholar 

  9. 9.

    Shakespeare DT, Rigby HS (1983) The bucket-handle tear of the meniscus: a clinical and arthrographic study. J Bone Joint Surg Br 65:383–387

    CAS  PubMed  Google Scholar 

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Correspondence to Jung-Ro Yoon.

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Yoon, JR., Muzaffar, N., Kang, JW. et al. A novel technique for arthroscopic reduction and repair of a bucket-handle meniscal tear. Knee Surg Sports Traumatol Arthrosc 17, 1332–1335 (2009). https://doi.org/10.1007/s00167-009-0785-1

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Keywords

  • Bucket-handle meniscal tear
  • Knee
  • Menisci
  • Reduction
  • Meniscal repair