A Systematic Anatomic Approach in the Repair of Bucket Handle Medial Meniscus Tear Associated With ACL Reconstruction (Retrospective Cohort Study)
A. Castro, F. Fernandes, L.R. Fernandes, A. Silva, C. QueirósObjective:
To evaluate the clinical outcomes, failure rate, and survivorship of a standardized hybrid meniscal repair technique for BHMTs performed concomitantly with ACL reconstruction and LEAP.
Methods:
A cohort of patients with BHMTs associated with ACL rupture treated between 2018 and June 2023 was retrospectively reviewed. All patients underwent arthroscopic meniscal repair using a standardized hybrid configuration combining posteromedial suture-hook stitches, one all-inside suture at the posteromedial meniscocapsular junction and outside-in sutures for the meniscal body, in conjunction with ACL reconstruction and lateral extra-articular procedure. Clinical outcomes were assessed and failure was defined as reoperation on the repaired meniscus. Kaplan–Meier survival analysis was performed.
Results:
Forty-three patients (31 men, 12 women; mean age 30.9 ± 8.1 years) were included, with a mean follow-up of 40.7 months (minimum 24 months). The mean Lysholm score at final follow-up was 83 ± 8, and the mean Tegner activity level was 6.3 ± 0.5. Three repair failures (7.0%) occurred at 16 to 23 months postoperatively, all following new traumatic events, and were treated with partial meniscectomy. No ACL graft failures were observed. No significant associations were found between failure and sex, graft type, anterolateral procedure, or number of sutures (p > 0.05). Minor complications were infrequent and resolved spontaneously.
Conclusion:
This standardized hybrid repair technique for BHMTs associated with ACL reconstruction provides satisfactory functional outcomes, low failure rates, and a favorable safety profile at mid-term follow-up.