The bucket handle meniscal tear. A technique using two incisions.

The bucket handle tear is a common meniscal tear in both the medial and lateral menisci, occurring in a relatively young age group, and with a high incidence of associated intra-articular pathology. Treatment of the tear consists of removal of the mobile fragment leaving a remaining meniscal rim that is both stable and smoothly contoured. This can be accomplished percutaneously under arthroscopic visualization. Numerous different methods for arthroscopic removal of the bucket handle fragment have been described and often in any particular situation, one method works slightly better than another. It is therefore important for a surgeon who routinely performs arthroscopic meniscal surgery to be comfortable with a wide variety of techniques and approaches. THe seven step technique that has been described is presently the easiest, most accurate, and most reliable technique in my experience. Progress, both in the development of new methods and in the development of better instrumentation, is extremely rapid in this field and therefore this technique must be considered in this context of rapid change.