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Bucket handle meniscus tear: what is it?

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A bucket handle meniscus tear is a specific knee injury where part of the meniscus is displaced in the joint, causing pain and swelling. It is common in active children and athletes and is usually treated with surgery. Recovery can take up to six months.

A bucket handle meniscus tear is a very specific type of knee injury that occurs when part of a supporting cartilaginous disc called the meniscus is displaced in the knee joint. The meniscus tears from the lower leg bones and essentially flips over, lodged in the joint. The mechanics of the injury can be compared to tipping the handle of a metal bucket from side to side. A bucket handle meniscus tear can be very painful and cause severe swelling and stiffness in the knee. The tear is usually treated with a minimally invasive surgical procedure to realign the meniscus and repair the damaged cartilage tissue.

Active children and competitive athletes are at the highest risk of suffering from this type of meniscus tear. A significant amount of force is required to separate the meniscus, and injuries are more likely to occur during high-impact sports such as soccer and basketball. A bucket handle meniscus tear can occur if the knee is forcefully rotated to one side during a tackle or if a person lands awkwardly after jumping in the air. In many cases, meniscus tears are accompanied by injuries to ligaments, tendons, and other structures in the leg.

An individual suffering from a bucket handle meniscus tear usually notices it right away. The pain is sharp, severe, and immediate, and an audible noise may be heard as the cartilage is separated from the bone. The knee tends to lock firmly in place, usually in a bent position. The swelling appears quickly and can persist for several days. It is important to seek medical evaluation as soon as possible following a serious knee injury.

A doctor can diagnose a bucket handle meniscus tear by examining the knee and asking about symptoms. Magnetic resonance imaging (MRI) scans are often done to determine the severity and exact location of a meniscus tear. If MRI findings are inconclusive in a patient with severe symptoms, an exploratory surgical procedure may be scheduled to confirm the problem.

Most patients who have bucket handle meniscus tears require corrective surgery. Resting and icing the knee may help relieve some symptoms, but the joint is unlikely to heal on its own without surgery. Arthroscopic knee surgery involves making two or more very small incisions in the front of the knee and using a lighted camera to guide the surgical tools. If there is no serious damage to the meniscus, it can be repositioned and secured with stitches.

A person can expect to spend at least six months recovering from meniscus surgery. He usually needs to wear a protective brace and use crutches for about six weeks to avoid aggravating the joint. Once the brace is removed, guided physical therapy can help an individual gradually rebuild strength and flexibility.

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