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A bucket handle meniscus tear is a very specific type of knee injury that occurs when part of a supportive cartilage disk called the meniscus is displaced in the knee joint. The meniscus tears away from the lower bones in the leg and essentially flips over, lodging itself in the joint. The mechanics of the injury can be compared to flipping the handle of a metal bucket from one side to the other. A bucket handle meniscus tear can be very painful and cause major swelling and stiffness in the knee. The injury is usually treated with a minimally-invasive surgical procedure to realign the meniscus and repair damaged cartilage tissue.
Active children and competitive athletes are at the highest risk of suffering these types of meniscus tears. A considerable amount of force is required to separate the meniscus, and injuries are most likely to occur during high impact sports such as football and basketball. A bucket handle meniscus tear may occur if the knee is forcefully twisted to one side during a tackle or if a person lands awkwardly after jumping into the air. In many cases, meniscus tears are accompanied by injuries to ligaments, tendons, and other structures in the leg.
An individual who suffers a bucket handle meniscus tear usually notices it right away. Pain is sharp, severe, and immediate, and an audible popping noise may be heard when the cartilage is separated from the bone. The knee tends to lock tightly into place, usually in a bent position. Swelling appears quickly and can persist for several days. It is important to seek medical evaluation as soon as possible following a major knee injury.
A physician can diagnose a bucket handle meniscus tear by examining the knee and asking about symptoms. Magnetic resonance imaging (MRI) scans are often performed to determine the severity and exact location of a meniscus tear. If MRI results are inconclusive in a patient with severe symptoms, he or she may be scheduled for an exploratory surgical procedure to confirm the problem.
Most patients who have bucket handle meniscus tears need corrective surgery. Resting and icing the knee may help to relieve some symptoms, but the joint is unlikely to heal itself without surgical intervention. Arthroscopic knee surgery involves making two or more very small incisions in the front of the knee and using a lighted camera to guide surgical tools. If there is no major damage to the meniscus, it can be flipped back into place and secured with stitches.
A person can expect to spend at least six months in recovery from meniscus surgery. He or she 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.