The bucket handle meniscal tear: a technique detaching the posterior segment first.
There are many perfectly satisfactory ways to remove bucket handle meniscal fragments under arthroscopic control, and there is nothing to be achieved by arguing the relative merits of dividing the back end before the front, the central approach or the anterolateral, or the role of the operating arthroscope. In my experience, the method described has proved reliable, simple, and quick, with an average operating time in the range of 20 minutes. Additional advantages are that the technique requires only simple hand instruments and that the formalized step-by-step approach makes both learning and teaching of the technique more straightforward. Although this technique has many advantages, it is not universally effective; there are times when it must be modified or another approach used instead, and other surgeons may find that other techniques suit the better. If there is a single "secret" of arthroscopic surgery, it is that the surgeon should have at his or her command a wide variety of arthroscopic approaches and techniques and be thoroughly confident in basic arthroscopic skills before attempting arthroscopic surgery. As in other fields of orthopedic surgery, technical success is based upon careful planning and the proper use of simple instruments handled correctly and precisely.
D020679:Arthroscopes; D001182:Arthroscopy; D003646:Debridement; D006801:Humans; D008592:Menisci, Tibial / Q000601:surgery*; D011182:Postoperative Care; D013525:Surgical Instruments; D000070600:Tibial Meniscus Injuries