Concurrent medial and lateral bucket handle meniscal tear repair in a chronic anterior cruciate ligament-deficient knee: a case report

Abstract

Bucket handle meniscus tears (BHMTs) are seen in the active population, especially young athletes. They often occur with anterior cruciate ligament (ACL) injury, causing significant knee symptoms and affecting the patients' quality of life. All-inside meniscus repair can be effective in the treatment for BHMT to improve symptoms and to preserve the native meniscus. We report a case of a 25-year-old female retired soccer player who presented with a three-year history of right knee pain, swelling and instability. She was diagnosed with BHMT of medial and lateral menisci and complete tear of the ACL on magnetic resonance imaging (MRI). She underwent arthroscopic medial and lateral meniscus repair with concomitant ACL reconstruction. Both the medial and lateral BHMT were reduced and repaired using an all-inside meniscus repair. We present her examination findings, functional outcomes and radiological imaging pre-operatively and 6 years post-operatively, which show an intact and stable ACL graft and repaired medial and lateral menisci with minimal progression to knee osteoarthritis. This shows that with good reduction and fixation, all-inside meniscus repair can achieve good mid-term results for the repair of bicompartmental chronic bucket handle tears.