Case Study: Management Of Bucket Handle Medial
Meniscus Tear Of The Right Knee In A Young Female

The patient is a 25-yr-old female, referred to our office by her primary care physician, with complaints of pain to the right knee. She suffered a twisting injury to her right knee when she slipped in the bathroom 2 months ago. Previously the patient had undergone right knee surgery in the form of ACL reconstruction and medial meniscus repair done by an outside physician 4 years ago.

The pain is mild to moderate in intensity. It is associated with swelling which has decreased over time. The patient describes the pain as aching. The pain not constant and does not disturb her sleep.

The patient denies any associated symptoms. The pain is not associated with bruising, tingling, numbness, radiating pain, weakness, bowel or bladder abnormality, gait problem, or limping, hand function difficulty. The problem has been getting better since it started. Activities such as walking, standing make the symptoms worse. Rest makes the symptoms better.

She has been using conservative management with ice and elevation and has been getting better. The swelling has decreased and she is able to walk comfortably.

The patient is currently working as a manager at her family restaurant and her work involves moving, bending, turning, and sitting for prolonged periods. The patient is a former smoker having quit 2 years ago. She denies any known drug allergies.

On examination of the right knee, the patient is tender to palpation along the medial joint line and has minimal effusion. Healed scars from prior ACL reconstruction with Hamstrings autograft are visible on inspection. 

The patient has discomfort with McMurray’s maneuvers, and the knee is stable. The ACL is intact on the Lachman test. The right knee lacks full extension but has full flexion. The lower extremity has 5/5 strength and is neurovascularly intact distally. There are no erythema, warmth, or skin lesions present.

On examination of the contralateral extremity, the patient is nontender to palpation and has an excellent range of motion, stability, and strength.

MRI of the right knee suggested a large bucket-handle tear of medial meniscus, displaced into the intercondylar notch and over the anterior horn.

MRI of the right knee in the sagittal and coronal section.

Various treatment options including surgical and non-surgical were discussed with the patient at length. The patient opted for surgical management.  We discussed risks, benefits, and complications of the treatment. The risks, benefits, alternatives, and complications were discussed with the patient at length. The patient understood and signed informed consent.

The patient underwent arthroscopic right medial meniscus repair. Post-op the patient remained stable. The patient was advised a locked knee brace and crutches for ambulation. A physical therapy and home exercise program was initiated with a gradual movement of the joint.

Disclaimer – Patient’s name, age, sex, dates, events have been changed or modified to protect patient privacy.