A bucket handle meniscus tear is an injury to the meniscus, a type of cartilage in your knee. This kind of injury often happens when you accidentally twist your knee during sports. This injury usually doesn’t get better on its own. But with the right treatment, you can get back on your feet again and resume your normal activities.
It's a tear in the crescent-shaped wedge of tough, rubbery cartilage in your knee called your meniscus. Your meniscus acts like a cushion between your thigh bone (femur) and shin bone (tibia). It absorbs shock in your knee and keeps it stable.
With a bucket handle tear, a tear forms in the center of your meniscus. This opening pushes the inside edge of your meniscus toward the middle of your knee. Because the ends of the meniscus are still attached to the knee joint and the outer edge remains curved, it looks like a handle on a bucket.
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In each knee, you have a lateral and medial meniscus. The lateral meniscus curves around the outer edge of your knee. The medial meniscus curves around the inner edge. A bucket handle tear can affect your lateral or medial meniscus, but it’s more common in the medial meniscus.
A bucket handle meniscus tear can happen to anyone, but it's more likely to occur if you play sports or exercise frequently. Twisting your knee while running or pivoting may cause a bucket handle meniscus tear.
A torn meniscus is one of the most common knee injuries. Bucket handle tears make up about 10% of all meniscus tears. This type of injury is more common in young men or people assigned male at birth.
Without treatment, a bucket handle tear can lead to arthritis in your knee and long-term knee pain. A meniscus tear also decreases your knee’s stability. Without a stable knee, you have a higher chance of getting another knee injury, like an ACL tear.
If you have a bucket handle meniscus tear, you may notice:
If you tear your meniscus, you might not have severe pain right away. You may even feel like you can continue to walk or play sports. But over the next two to three days, your knee may become swollen, stiff or painful.
Most bucket handle tears happen when you suddenly twist or turn your knee during sports or exercise. Playing sports that require you to pivot or quickly start and stop is a common cause.
You can also tear your meniscus if you slip, fall or step on an uneven surface. Some people accidentally twist their knee while doing everyday activities, such as getting out of bed or up from a chair.
First, your provider will perform a physical examination. Tell your provider how your knee feels and when you first noticed symptoms.
Your provider might perform a McMurray Test or Thessaly test, where they gently turn or move your leg in different directions. This test helps your provider determine what type of knee injury you may have.
After your physical exam, you may need imaging tests. These tests take pictures of the inside of your knee so your provider can see the meniscus and other tissues. Your tests may include:
If you have a bucket handle meniscus tear, your treatment options may include:
The most common treatment for a bucket handle meniscus tear is meniscus surgery, also called knee arthroscopy. During this surgery, your surgeon uses an arthroscope (tiny camera) to see inside your knee. The arthroscope projects images on a screen so your surgeon can see the meniscus without a large incision.
Bucket handle meniscus tears often respond well to meniscus surgery because they usually have good blood supply. During your surgery, your surgeon moves the “bucket flap” portion of the meniscus back to its proper place and attaches it with stitches. Recovery from this surgery takes six weeks to three months.
If your meniscus can't be repaired with surgery, your provider may talk with you about meniscal transplantation. Also called a meniscus transplant or meniscus replacement, this is surgery to replace a damaged or missing meniscus. If you had your meniscus removed with a prior surgery because it couldn’t be repaired, meniscal transplantation may be an option. During this surgery, your provider transplants a meniscus from a deceased donor.
A meniscus transplant can help prevent osteoarthritis and future knee pain. You might be eligible for this surgery if:
Platelet-rich plasma is a treatment that uses your own blood to repair injuries and encourage healing. Your provider may recommend PRP therapy for a bucket handle meniscus tear, usually after you’ve had meniscus surgery. The platelets and plasma from your blood boost healing in torn or damaged tissues. This therapy uses a concentrated form of these blood parts to treat injuries.
During PRP therapy, your provider:
Your provider may prescribe physical therapy, which includes special exercises you do after surgery. These exercises help build strength and flexibility and are tailored to your injury and needs. Your physical therapist guides you through your exercises during your sessions. You continue working on some exercises at home. Following your physical therapy plan gives you the best chance for a successful recovery.
There’s no guaranteed way to prevent a bucket handle tear. But if you’re active or play sports, these steps can help you lower your chance of any type of knee injury:
The outlook after a successful bucket handle meniscus repair is favorable. Most people who have successful meniscus surgery go back to normal activities after recovery. With a repaired or transplanted meniscus, you have a lower chance of getting osteoarthritis in your knee later.
Some minor meniscus tears can heal on their own with rest and careful home care. However, most bucket handle tears don't get better on their own. The separated portion is often stuck in the middle of your knee. This piece can't move back or heal by itself, so you need a surgeon to put it back in place.
If you have symptoms of a bucket handle tear or heard a pop in your knee, see your provider. Even meniscus tears that aren’t very painful can result in osteoarthritis and other knee problems later if you don’t receive treatment.
After any type of surgery, you should watch for signs of rare complications. If you recently had knee surgery, seek emergency care if you have:
A note from Cleveland Clinic
A bucket handle meniscus tear may sideline you for a few weeks or months. But this injury doesn’t have to stop you from enjoying exercise and sports again. After successful treatment, most people resume their normal activities. Talk to your provider about the best options for meniscus repair based on your needs and lifestyle.
Last reviewed by a Cleveland Clinic medical professional on 07/29/2022.
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