Arthroscopically Repaired Bucket-Handle Meniscus Tears: Patient Demographics, Postoperative Outcomes, and a Comparison of Success and Failure Cases. (January 2020)

• Record Type: Journal Article
• Authors: Saltzman, Bryan M.; Cotter, Eric J.; Wang, Kevin C.; Rice, Richard; Manning, Blaine T.; Yanke, Adam B.; Forsythe, Brian; Verma, Nikhil N.; Cole, Brian J.
• Is Part Of: Cartilage. Volume 11:Number 1(2020)
• Page Start: 77
• Page End: 87
• Publication Date: 2020-01
• Subjects: meniscus -- tear -- bucket-handle -- repair; Cartilage -- Periodicals; 616.7
• DOI: 10.1177/1947603518783473
• Languages: English
• ISSNs: 1947-6035

Abstract

Objective: To define patient demographics, preoperative, and intraoperative surgical variables associated with successful or failed repair of bucket-handle meniscal tears. Design: All patients who underwent arthroscopic repair of a bucket-handle meniscus tear at a single institution between May 2011 and July 2016 with minimum 6-month follow-up were retrospectively identified. Patient demographic, preoperative (including imaging), and operative variables were collected and evaluated. A Kaplan-Meier curve was generated to demonstrate meniscus repair survivorship. Results: In total, 75 patients (78 knees) with an average age of 26.53 ± 10.67 years met inclusion criteria. The average follow-up was 23.41 ± 16.43 months. Fifteen knees (19.2%) suffered re-tear of the repaired meniscus at an average 12.24 ± 9.50 months postoperatively. Survival analysis demonstrated 93.6% survival at 6 months, 84.6% survival at 1 year, 78.4% survival at 2 years, and 69.9% survival at 3 years. There was significant improvement from baseline to time of final follow-up in all patient-reported outcome ( P < 0.05) except Marx score ( P = 0.933) and SF-12 Mental Subscale ( P = 0.807). The absence of other knee pathology (including ligament tear, contralateral compartment meniscal tear, or cartilage lesions) noted intraoperatively was the only variable significantly associated with repair failure ( P = 0.024). Concurrent anterior cruciate ligament reconstruction (vs. no concurrent anterior cruciate ligament reconstruction) trended toward significance ( P = 0.059) as a factor associated with successful repair. Conclusions: With the exception of the absence of other knee pathology (including ligament tear, contralateral compartment meniscal tear, or cartilage lesions) noted intraoperatively, no other variables were significantly associated with re-tear. The results are relatively durable with 84.6% survival at 1 year. Surgeons should attempt meniscal repair when presented with a bucket-handle tear.