A 28-year-old male basketball player presents with medial knee pain and clicking after a twisting injury. McMurray's test is positive for medial meniscus pathology. MRI shows a vertical longitudinal tear of the medial meniscus extending into the posterior horn (bucket handle tear). The meniscus is displaced into the intercondylar notch. The preferred treatment is:
- A Conservative management with physiotherapy for 6 weeks
- B Arthroscopic meniscal repair to preserve meniscal tissue ✓
- C Arthroscopic partial meniscectomy (trimming of the displaced fragment)
- D Total meniscectomy via open arthrotomy
Explanation
Bucket handle meniscal tears in young active patients, especially in the vascular outer one-third ('red-red' or 'red-white' zones), should be repaired arthroscopically (suture repair techniques: inside-out, outside-in, all-inside) to preserve meniscal tissue and prevent long-term articular cartilage deterioration from post-meniscectomy syndrome. Meniscal repair has 80-90% success rates in the vascular zone. Meniscectomy (even partial) accelerates OA development. The meniscus provides 50-70% of the compressive load distribution at the tibiofemoral joint and acts as a shock absorber.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.