The knee joint has a strong and stable structure. It consists of bones, muscles, tendons and cartilages that provides adequate support to the joint structure. Meniscus is a cartilage disk made of elastic fibrous tissue. At the knee joint, it lies in between the femur bone and tibia bone and acts like a cushion that prevents the bones from getting rubbed against each other. There are two crescent shaped menisci in each knee joint. One of them is located in the outer part of the knee called lateral cartilage meniscus and the other one lies in the inner part of the knee called medial cartilage meniscus. Basically, this fibrous cartilage of knee is fragile in nature and hence, tears tend to develop on them quite easily.
Bucket Handle Meniscus Tear
Torn meniscus is a very common form of knee injury. Any such activity that involves forceful twisting or turning of the knee joint leads to meniscus tear. There are many different types of meniscus tear, which include longitudinal tear, horizontal tear, radial tear, flap tear, posterior horn tear, etc. A bucket handle meniscus tear is a severe form of longitudinal or vertical tear where the central part of cartilage tissue gets detached from the tibia bone and is displaced from its position. Thus, a flap is formed that looks very similar to a bucket handle. It occurs mostly around the edge of the meniscus. As compared to lateral meniscus, it is the medial meniscus, which is more susceptible to this kind of damage. This is commonly found in young people who are physically active. Athletes often sustain this kind of injury during an aggressive rotation of the knee, sudden stops while running fast, lifting of heavy weight on the knees, deep squatting, etc.
This meniscal tear is typically characterized by locking of the knee. This happens intermittently and that too all of a sudden but disappears on its own after some time. In this condition, the knee joint cannot be fully extended or straightened. If you try to stretch the knee, you will experience severe pain. Other symptoms include knee pain, which aggravates with squatting, stiff and swollen knees, clicking knee, etc.
A bucket handle tear is first diagnosed with the help of its symptoms and physical examination of the injured knee. It is then confirmed with imaging tests like X-rays and MRI scan. Initially, doctors may monitor the situation for a while and allow the tear to heal without any surgery. For this, the patient is advised to give adequate amount of rest to the affected knee. Twisting of the knee is strictly prohibited. Crutches should be used to reduce pressure from the knees. During this time, pain and swelling of the knees is controlled with the help of pain relieving medicines. Ice application for 10-15 minutes after a gap of 3-4 hours can also reduce the painful symptoms.
If it does not heal on its own, then doctors opt for arthroscopic surgery for bucket handle meniscal tear treatment. In this procedure, surgeons make a small incision near the knee and insert an arthroscope, which consists of a light and a small-sized camera. Another small incision is made to insert surgical instruments and the surgery is conducted. If the location of the tear is at an extreme edge of the meniscus, then it can be repaired. Otherwise, the torn part of the meniscus has to be shaved away. After the meniscus surgery, the knee is put in a cast or knee brace for at least two weeks in order to keep it in an immobile state. It is followed by a rehabilitation program where the patient has to undergo physical therapy. The physical therapist recommends some exercises that can improve the strength and mobility of the knees.
Most cases of bucket handle meniscus tear can be treated successfully and a patient can get back into a normal active lifestyle all over again. The recovery time for a minor tear is 2-3 weeks. However, in those cases where it is repaired by surgery, the recovery time could be more than 6 weeks. In fact, it may take 2-3 months before one can fully recover from it and resume normal life activities.