Acute Anterior Cruciate Ligament Injury with Medial and Lateral Bucket-Handle Meniscus Tears

Abstract We report the case of a healthy 31-year-old female professional billiard player presented with a 5-day history of severe left knee pain after a fall. A magnetic resonance imaging of the left knee showed that she had suffered an anterior cruciate ligament (ACL) rupture along with buckle-handle tears of both the medial and lateral meniscus. Both of these menisci had flipped anterior and centrally to the femoral condyles and were lodged in the notch. The patient had also suffered a mild injury to the medial collateral ligament. Repair of both menisci was performed using an inside-out technique. Following this, an ACL reconstruction was done using a quadrupled hamstring autograft. Endobutton fixation (Smith & Nephew, Andover, MA) was used on the femur with a screw and sheath used for tibial fixation. The patient tolerated the procedure well and was sent home the same day. This case demonstrates the typical signs and symptoms of a displaced bucket-handle meniscus tear as well as imaging and arthroscopic pictures.

[1]  C. Fink,et al.  Anterior cruciate ligament injury with simultaneous locked bucket-handle tears of both medial and lateral meniscus in a 19-year-old female professional ski racer: a case report , 2007, Knee Surgery, Sports Traumatology, Arthroscopy.

[2]  U. Bosch [Combined injury of the medial and lateral meniscus and the anterior cruciate ligament]. , 2006, Operative Orthopädie und Traumatologie.

[3]  P. Thoreux,et al.  Bucket-handle meniscal lesions: magnetic resonance imaging criteria for reparability. , 2006, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[4]  M. Uslu,et al.  Simultaneous bucket handle tear of both medial and lateral menisci of a knee with chronic anterior cruciate ligament deficiency , 2006, Knee Surgery, Sports Traumatology, Arthroscopy.

[5]  D. Verettas,et al.  Meniscal bucket handle tears: a retrospective study of arthroscopy and the relation to MRI , 2006, Knee Surgery, Sports Traumatology, Arthroscopy.

[6]  R. Ramnath,et al.  The quadruple cruciate sign of simultaneous bicompartmental medial and lateral bucket-handle meniscal tears , 2005, Skeletal Radiology.

[7]  S. Gill,et al.  Outcomes after meniscal repair using the meniscus arrow in knees undergoing concurrent anterior cruciate ligament reconstruction. , 2002, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[8]  P. Greis,et al.  Meniscal injury: I. Basic science and evaluation. , 2002, The Journal of the American Academy of Orthopaedic Surgeons.

[9]  S. Erickson,et al.  Simultaneous identification of medial and lateral bucket-handle tears: the Jack and Jill lesion. , 1999, AJR. American journal of roentgenology.

[10]  T. Magee,et al.  MRI of meniscal bucket-handle tears , 1998, Skeletal Radiology.

[11]  A. D. De Smet,et al.  Bucket-handle tears of the medial and lateral menisci of the knee: value of MR imaging in detecting displaced fragments. , 1995, AJR. American journal of roentgenology.

[12]  D. Bickerstaff,et al.  The natural history of meniscal tears in anterior cruciate ligament insufficiency , 1993, The American journal of sports medicine.

[13]  G. Mann,et al.  Secondary damage to the knee after isolated injury of the anterior cruciate ligament , 1990, The American journal of sports medicine.

[14]  B. Baker,et al.  Review of meniscal injury and associated sports , 1985, The American journal of sports medicine.

[15]  W. Clancy,et al.  Arthroscopic meniscal repair. , 1983, Orthopedics.

[16]  D. Shakespeare,et al.  The bucket-handle tear of the meniscus. A clinical and arthrographic study. , 1983, The Journal of bone and joint surgery. British volume.

[17]  A. Scala,et al.  Different patterns of meniscal tears in acute anterior cruciate ligament (ACL) ruptures and in chronic ACL-deficient knees , 2005, Knee Surgery, Sports Traumatology, Arthroscopy.