Your Knee and a Bucket Handle Tear

What is Your Knee?

Your knee is your kneecap. You have two kinds of knees: anterior (front) and posterior (rear). Anterior knee refers to the front part of the knee joint, while posterior knee refers to the rear part of the knee joint. When you bend forward, your kneecap bends backward toward your body. That’s why when you bend over with bent legs, your knees are bent at 90 degrees.

Anatomy of Your Knee Joint

The kneecap consists of three bones: the tibia, fibula, and patella. These bones form a triangular shape. The kneecap is connected to the rest of your leg bone by ligaments and tendons. Ligaments connect to other muscles or tendons. Tendons attach to bone.

If one tendon attaches to another, then they become attached. For example, if your quadriceps muscle attaches to your gastrocnemius muscle, then those tendons will become attached and make you stronger.

When Your Knees Hurt

If there is a tear in the kneecap, it may cause pain in both knees when you bend forward. In severe cases, it may cause swelling and redness.

How Does the Meniscus Work?

Tears in your meniscus are common. The meniscus is a c-shaped disc that acts like a shock absorber for your knee. The meniscus can tear when you twist or bend sideways. The most common places for tears to occur are the inner and outer edges of the meniscus. Tears can also happen in the middle of the meniscus. Tears are graded from 1 to 3, with 3 being the most severe. The grading is determined by how much of the meniscus is torn and the location of the tear.

How Common Are Bucket-handle Meniscal Tears?

Bucket-handle meniscal tears are common. They make up about 25% of all knee tears. Meniscal tears are more common in people who do a lot of twisting or pivoting, such as baseball catchers or skiers.

Common Causes of Bucket-handle Meniscus Tears

Bucket-handle meniscal tears usually happen over time as a result of normal wear and tear. However, some people experience a sudden twisting injury to the knee that causes a bucket-handle tear. This can be caused by jumping and landing awkwardly or being struck on the outside of your knee. Bucket-handle tears are more common in people who do a lot of heavy lifting or pivoting sports.

How Is a Bucket-handle Meniscus Tear Diagnosed?

Your doctor will examine your knee and move it through a range of motion. He or she will twist and bend your knee to see if this causes pain. Your doctor will also ask if you’ve had any injuries that involved a sudden twisting of your knee. If the diagnosis is uncertain, your doctor may order an MRI. An MRI can provide a clear image of your meniscus.

How Is a Bucket-handle Meniscus Tear Treated?

Surgery is usually required to repair a bucket-handle tear. Some tears can be repaired through a small incision in the knee, but larger tears or more extensive damage may require a larger incision. The surgical procedure is called an ACL reconstruction. For small tears without any other damage to the meniscus or bone, your surgeon may choose to trim the torn edges of the tear in order to stabilize it.

Recovery From Bucket-handle Meniscal Tear Surgery

Bucket-handle tears can be slow to heal. The rehabilitation period can take several months. During this time, you will need to use crutches and ice your knee several times per day. Your doctor may also give you a brace to wear while your knee heals. You will need to follow the proper rehabilitation protocol in order to restore strength and flexibility to your knee.

If you are unable to return to your normal level of activity, then you should seek medical attention immediately. If not treated properly, long-term consequences can include swelling, bone erosion, knee stiffness, and difficulty walking. If you would like more information on bucket-handle tears, please contact us. We can help.

Sources & references used in this article:

Bucket-handle tear of the medial meniscus. A case for conservative surgery by AO Cargill, JP Jackson – JBJS, 1976 –

Meniscal repair compared with meniscectomy for bucket-handle medial meniscal tears in anterior cruciate ligament-reconstructed knees by KD Shelbourne, DR Carr – The American Journal of Sports …, 2003 –

Repair of locked bucket-handle meniscal tears in knees with chronic anterior cruciate ligament deficiency by JJ O’Shea, KD Shelbourne – The American Journal of Sports …, 2003 –

… Evaluation of Medial Joint Space Narrowing after Partial Meniscectomy of Bucket-Handle Medial Meniscus Tears in Anterior Cruciate Ligament–Intact Knees by KD Shelbourne, JF Dickens – The American Journal of …, 2006 –

Central hole tear of the discoid meniscus of the knee in magnetic resonance imaging: mimicking the bucket-handle tear by JW Choi, HW Chung, JH Ahn… – Journal of computer …, 2009 –

Bucket-handle meniscal tears of the knee: sensitivity and specificity of MRI signs by TA Dorsay, CA Helms – Skeletal radiology, 2003 – Springer

Spontaneous healing of a bucket-handle lateral meniscal tear in an anterior cruciate ligament-deficient knee: A case report by DR McAllister, AR Motamedi – The American journal of …, 2001 –