title: Outcomes after repair of chronic bucket-handle tears of medial meniscus.
abstract: OBJECTIVE
  The purpose of this study was to determine the outcomes after repair of chronic bucket-handle medial meniscal tears by use of magnetic resonance imaging, clinical examination, and patient-reported outcomes.
  
  
  METHODS
  A retrospective review of patients with chronic bucket-handle medial meniscal tears that had been repaired with meniscal sutures was undertaken. The following criteria for inclusion were adopted: minimum tear length of 2 cm and chronic medial meniscal tear identified at the time of arthroscopy. The tears were susceptible to dislocation with probing. Data collected included demographic, clinical, radiologic, and surgical data. Postoperative healing was assessed with the clinical criteria of Barrett et al. The International Knee Documentation Committee rating, Lysholm score, and Tegner activity level were determined, and postoperative magnetic resonance imaging was used to evaluate healing in accordance with the criteria of Henning et al.
  
  
  RESULTS
  Twenty-four patients fulfilled the inclusion criteria. The mean time from injury to surgery was 10 months (range, 2 to 60 months). Sixteen patients underwent anterior cruciate ligament reconstruction, 1 patient underwent posterior cruciate ligament reconstruction, and 6 patients underwent meniscus repair only. A median of 5 sutures (range, 3 to 6 sutures) were used for repair. Four cases (all of which had undergone meniscus repair only) required revision. Complete healing was achieved in 83% of cases according to the criteria of Barrett et al. The mean follow-up time was 48 months (range, 24 to 112 months). An International Knee Documentation Committee rating of A or B was achieved in the 20 patients who did not require revision. The median Lysholm score was 95 (range, 92 to 100). The median Tegner activity level before injury was 7, and it remained unchanged after surgery in all cases.
  
  
  CONCLUSIONS
  This study showed that repair of chronic bucket-handle meniscal tears can lead to good clinical outcomes and a relatively low (17%) failure rate. In addition, repairs of isolated meniscal tears had a significantly higher risk of failure than repairs performed in conjunction with anterior cruciate ligament reconstruction.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Complejo Hospitalario de Jaén, Jaén, Spain. Electronic address: alesre001@gmail.com.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Espejo-Reina
authors.affiliation: Hospital Universitario Virgen de la Victoria, Málaga, Spain.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Serrano-Fernández
authors.affiliation: Hospital Universitario Virgen de la Victoria, Málaga, Spain; Hospital Parque San Antonio, Málaga, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Martín-Castilla
authors.affiliation: Hospital Universitario Virgen de la Victoria, Málaga, Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Estades-Rubio
authors.affiliation: Center for Outcomes-Based Orthopaedic Research, Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Briggs
authors.affiliation: Hospital Universitario Virgen de la Victoria, Málaga, Spain; Hospital Parque San Antonio, Málaga, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Espejo-Baena
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D012189:Retrospective Studies; D012421:Rupture; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome; D055815:Young Adult