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Arthroscopic repair of bucket-handle tears of the lateral meniscus

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study was undertaken to document the clinical results of arthroscopic meniscus repair for treatment of displaced bucket-handle tears of the lateral meniscus.

Methods

From 2002 to 2010, 13 patients with symptomatic displaced bucket-handle tears of the lateral meniscus treated by arthroscopic meniscus repair were included in this study. Inclusion criteria were (1) displaced bucket-handle tear of the lateral meniscus demonstrated on magnetic resonance imaging, (2) non-discoid lateral meniscus, (3) stable knee, and (4) tears involving the red-white or red–red zone. Median age at operation was 20 years (range 14–54 years), and the median follow-up period was 4.0 years (range 2–10.7 years). All tears were repaired with either a modified all-inside suture technique only or a combination of the modified all-inside suture and modified outside-in techniques. Clinical results were evaluated preoperatively and at the final follow-up using Tegner activity level, Lysholm knee, and Hospital for Special Surgery (HSS) scores.

Results

All patients returned to their prior life activities with little or no limitations, and no reoperations were required during the follow-up period. On the final follow-up, all knees achieved full range of motion, except two knees with limited function during squatting and jumping due to pain. No patient had recurrence of a knee-locking episode. The median Tegner activity level improved significantly from 3 (2–6) to 7 (4–9) (p < 0.0001), mean Lysholm knee score improved from 78.5 ± 10.7 preoperatively to 94.6 ± 5.4 (p < 0.0001), and mean preoperative HSS score improved from 80.3 ± 8.5 to 95.9 ± 4.2 (p < 0.0001) during the follow-up period.

Conclusion

Arthroscopic meniscus repair using the modified all-inside suture and modified outside-in techniques showed excellent clinical outcomes for treatment of symptomatic displaced bucket-handle tears of the lateral meniscus and were free of any complications or episodes of recurrence.

Level of evidence

Case series, Level IV.

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References

  1. Ahn JH, Oh I (2006) Arthroscopic all-inside lateral meniscus suture using posterolateral portal. Arthroscopy 22(572):e571–e574

    Google Scholar 

  2. Ahn JH, Wang JH, Yoo JC, Kim SK, Park JH, Park JW (2006) The modified outside-in suture: vertical repair of the anterior horn of the meniscus after decompression of a large meniscal cyst. Knee Surg Sports Traumatol Arthrosc 14:1288–1291

    Article  PubMed  Google Scholar 

  3. Ahn JH, Yoo JC, Lee SH (2012) Posterior horn tears: all-inside suture repair. Clin Sports Med 31:113–134

    Article  PubMed  Google Scholar 

  4. Anderson K, Marx RG, Hannafin J, Warren RF (2000) Chondral injury following meniscal repair with a biodegradable implant. Arthroscopy 16:749–753

    Article  CAS  PubMed  Google Scholar 

  5. Austin KS, Sherman OH (1993) Complications of arthroscopic meniscal repair. Am J Sports Med 21:864–868

    Article  CAS  PubMed  Google Scholar 

  6. Barber FA, Bava ED (2012) Meniscal repair: the newest fixators. Sports Med Arthrosc 20:95–100

    Article  PubMed  Google Scholar 

  7. Breitenseher MJ, Trattnig S, Dobrocky I, Kukla C, Nehrer S, Steiner E, Imhof H (1997) MR imaging of meniscal subluxation in the knee. Acta Radiol 38:876–879

    Article  CAS  PubMed  Google Scholar 

  8. Brown GC, Rosenberg TD, Deffner KT (1996) Inside-out meniscal repair using zone-specific instruments. Am J Knee Surg 9:144–150

    CAS  PubMed  Google Scholar 

  9. Cannon WD Jr (1996) Arthroscopic meniscal repair. Inside-out technique and results. Am J Knee Surg 9:137–143

    PubMed  Google Scholar 

  10. Cohn AK, Mains DB (1979) Popliteal hiatus of the lateral meniscus. Anatomy and measurement at dissection of 10 specimens. Am J Sports Med 7:221–226

    Article  CAS  PubMed  Google Scholar 

  11. Dervin GF, Downing KJ, Keene GC, McBride DG (1997) Failure strengths of suture versus biodegradable arrow for meniscal repair: an in vitro study. Arthroscopy 13:296–300

    Article  CAS  PubMed  Google Scholar 

  12. Diamantopoulos A, Tokis A, Tzurbakis M, Patsopoulos I, Georgoulis A (2005) The posterolateral corner of the knee: evaluation under microsurgical dissection. Arthroscopy 21:826–833

    Article  PubMed  Google Scholar 

  13. Garofalo R, Kombot C, Borens O, Djahangiri A, Mouhsine E (2005) Locking knee caused by subluxation of the posterior horn of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc 13:569–571

    Article  PubMed  Google Scholar 

  14. George M, Wall EJ (2003) Locked knee caused by meniscal subluxation: magnetic resonance imaging and arthroscopic verification. Arthroscopy 19:885–888

    Article  PubMed  Google Scholar 

  15. Hagino T, Ochiai S, Watanabe Y, Senga S, Wako M, Ando T, Sato E, Haro H (2012) Clinical results of arthroscopic all-inside lateral meniscal repair using the Meniscal Viper Repair System. Eur J Orthop Surg Traumatol. doi:10.1007/s00590-012-1138-1

    PubMed  Google Scholar 

  16. Higuchi H, Kimura M, Kobayashi A, Hatayama K, Takagishi K (2004) A novel treatment of hypermobile lateral meniscus with monopolar radiofrequency energy. Arthroscopy 20(Suppl 2):1–5

    Article  PubMed  Google Scholar 

  17. Horibe S, Shino K, Nakata K, Maeda A, Nakamura N, Matsumoto N (1995) Second-look arthroscopy after meniscal repair. Review of 132 menisci repaired by an arthroscopic inside-out technique. J Bone Joint Surg Br 77:245–249

    CAS  PubMed  Google Scholar 

  18. Kimura M, Shirakura K, Hasegawa A, Kobayashi Y, Udagawa E (1992) Anatomy and pathophysiology of the popliteal tendon area in the lateral meniscus: 2. Clinical investigation. Arthroscopy 8:424–427

    Article  CAS  PubMed  Google Scholar 

  19. LaPrade RF, Konowalchuk BK (2005) Popliteomeniscal fascicle tears causing symptomatic lateral compartment knee pain: diagnosis by the figure-4 test and treatment by open repair. Am J Sports Med 33:1231–1236

    Article  PubMed  Google Scholar 

  20. Makdissi M, Eriksson KO, Morris HG, Young DA (2006) MRI-negative bucket-handle tears of the lateral meniscus in athletes: a case series. Knee Surg Sports Traumatol Arthrosc 14:1012–1016

    Article  PubMed  Google Scholar 

  21. Metcalf MH, Barrett GR (2004) Prospective evaluation of 1,485 meniscal tear patterns in patients with stable knees. Am J Sports Med 32:675–680

    Article  PubMed  Google Scholar 

  22. Nakamae A, Deie M, Yasumoto M, Kobayashi K, Ochi M (2004) Synovial cyst formation resulting from nonabsorbable meniscal repair devices for meniscal repair. Arthroscopy 20(Suppl 2):16–19

    Article  PubMed  Google Scholar 

  23. Ohtoshi K, Kimura M, Kobayashi Y, Higuchi H, Kikuchi S (2004) Arthroscopic thermal shrinkage for hypermobile lateral meniscus. Am J Sports Med 32:1297–1301

    Article  PubMed  Google Scholar 

  24. Park JH, Ro KH, Lee DH (2012) Snapping knee caused by a popliteomeniscal fascicle tear of the lateral meniscus in a professional Taekwondo athlete. Orthopedics 35:e1104–e1107

    Article  PubMed  Google Scholar 

  25. Sakai H, Sasho T, Wada Y, Sano S, Iwasaki J, Morita F, Moriya H (2006) MRI of the popliteomeniscal fasciculi. AJR Am J Roentgenol 186:460–466

    Article  PubMed  Google Scholar 

  26. Servien E, Acquitter Y, Hulet C, Seil R (2009) Lateral meniscus lesions on stable knee: a prospective multicenter study. Orthop Traumatol Surg Res 95:S60–S64

    Article  CAS  PubMed  Google Scholar 

  27. Simonian PT, Sussmann PS, van Trommel M, Wickiewicz TL, Warren RF (1997) Popliteomeniscal fasciculi and lateral meniscal stability. Am J Sports Med 25:849–853

    Article  CAS  PubMed  Google Scholar 

  28. Simonian PT, Sussmann PS, Wickiewicz TL, Potter HG, van Trommel M, Weiland-Holland S, Warren RF (1997) Popliteomeniscal fasciculi and the unstable lateral meniscus: clinical correlation and magnetic resonance diagnosis. Arthroscopy 13:590–596

    Article  CAS  PubMed  Google Scholar 

  29. Small NC (1988) Complications in arthroscopic surgery performed by experienced arthroscopists. Arthroscopy 4:215–221

    Article  CAS  PubMed  Google Scholar 

  30. Song EK, Lee KB, Yoon TR (2001) Aseptic synovitis after meniscal repair using the biodegradable meniscus arrow. Arthroscopy 17:77–80

    Article  CAS  PubMed  Google Scholar 

  31. Suganuma J, Mochizuki R, Inoue Y, Yamabe E, Ueda Y, Kanauchi T (2012) Magnetic resonance imaging and arthroscopic findings of the popliteomeniscal fascicles with and without recurrent subluxation of the lateral meniscus. Arthroscopy 28:507–516

    Article  PubMed  Google Scholar 

  32. Terzidis IP, Christodoulou A, Ploumis A, Givissis P, Natsis K, Koimtzis M (2006) Meniscal tear characteristics in young athletes with a stable knee: arthroscopic evaluation. Am J Sports Med 34:1170–1175

    Article  PubMed  Google Scholar 

  33. Yue BW, Gupta AK, Moorman CT III, Garrett WE, Helms CA (2011) Wrisberg variant of the discoid lateral meniscus with flipped meniscal fragments simulating bucket-handle tear: MRI and arthroscopic correlation. Skeletal Radiol 40:1089–1094

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors report no conflict of interest/financial disclosure.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Jin Hwan Ahn

  2. Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Korea

    Kang-Il Kim, Min Chul Seo & Sang Hak Lee

  3. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Joon Ho Wang & Bong Soo Kyung

  4. Department of Orthopaedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, Korea

    Sang Hak Lee

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  1. Jin Hwan Ahn
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  2. Kang-Il Kim
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Correspondence to Sang Hak Lee.

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Ahn, J.H., Kim, KI., Wang, J.H. et al. Arthroscopic repair of bucket-handle tears of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc 23, 205–210 (2015). https://doi.org/10.1007/s00167-013-2764-9

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  • DOI: https://doi.org/10.1007/s00167-013-2764-9

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