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A bucket-handle tear of the knee is a specific type of meniscal injury characterized by a longitudinal tear of the medial or lateral meniscus, where a displaced inner fragment resembles the appearance of a "bucket handle". [1]
A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci.When doctors and patients refer to "torn cartilage" in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae.
The meniscus is a C-shaped piece of fibrocartilage located at the peripheral aspect of the knee joint that offers lubrication and nutrition to the joint. Each knee has two menisci, medial and lateral, whose purpose is to provide space between the tibia and the femur, preventing friction and allowing for the diffusion of articular cartilage.
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Acute injury to the medial meniscus frequently accompanies an injury to the ACL (anterior cruciate ligament) or MCL (medial collateral ligament). A person occasionally injures the medial meniscus without harming the ligaments. Healing of the medial meniscus is generally not possible unless the patient is very young, usually <15 years old.
If the tear causes continued pain, swelling, or knee dysfunction, then the tear can be removed or repaired surgically. The unhappy triad is a set of commonly co-occurring knee injuries which includes injury to the medial meniscus.
Bilateral valgus stress AP images can show a difference in medial joint space gapping. It has been reported that an isolated grade III sMCL tear will show an increase in medial compartment gapping of 1.7 mm at 0° of knee flexion and 3.2 mm at 20° of knee flexion, compared to the contralateral knee.
A tear in the meniscus may cause a pedunculated tag of the meniscus which may become jammed between the joint surfaces. To perform the test, the knee is held by one hand, which is placed along the joint line, and flexed to complete flexion while the foot is held by the sole (of the foot) with the other hand.