A bucket-handle tear is a special kind of displaced circumferential tear of the knee meniscus, where the free bit flips over like the handle of a bucket.

Page updated February 2024 by Dr Sheila Strover (Clinical Editor)

locked bucket handle tear

 

The knee becomes 'locked' when the longitudinal tear flips over. trapping the condyle from moving freely.

 

bucket-handle tear of the meniscus

 

Illustration of the meniscus with the displaced longitudinal tear, which resembles a flipped bucket handle.

bucket handle

 

Illustration of a bucket, where the handle can flip either way. So sometimes a bucket-handle tear of the meniscus can spontaneously reduce, with motion restored.

 

Natural history of the 'bucket-handle'

The circumferential (longitudinal) tear occurs first, and the locking follows later, but with each episode the tear may extend and the 'handle' bit may flip over more easily. Eventually the 'handle' may break and its free end may flap in the joint, causing periodic catching or locking. Eventually the torn bit may break off altogether, to float in the joint as a 'loose body', also causing intermittent catching or locking.

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Routine management of bucket-handle tears

In most cases of bucket-handle tear, today's surgeon will generally attempt a repair procedure, rather than cutting away the 'handle', although sometimes there is simply too much damage to preserve the whole meniscus.

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Management of a locked bucket-handle tear

A patient may find that the displaced portion flips back on its own, with immediate relief of locking - but the locking may recur, and each episode may cause the tear to extend. The best route is for the surgeon to flip the torn bit back early and suture it in position until it heals.

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Forum discussions

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Synonyms: 
Displaced meniscal tear
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Dr Sheila Strover (Editor)
BSc (Hons), MB BCh, MBA

See biography...

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Types of meniscal tear -

Bucket-handle symptoms -


 

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