Complex Meniscus Tear Injuries
Bucket Handle meniscus tear. What is Bucket Handle meniscus tear? The meniscus is a cartilage present in the knee joint. The knee is composed of two menisci, one located in the inner side of the knee (medial meniscus) and one located in the outer side of the knee (lateral meniscus). Arthroscopy is the method used to repair a bucket handle tear. During the procedure, the arthroscopy is conducted by placing a small camera in the knee to see the meniscus tear. In most cases, bucket handle tears are usually flipped over and stuck in the middle of the knee. So during the procedure, the flat needs to be put back into its position.
Meniscus Tears. Posterior Horn Meniscus Tears. Complex Meniscus Tears. Meniscus Anatomy. Symptoms of a Meniscus Tear. Causes of a Meniscus Injury. Diagnosing a Meniscus Injury. Meniscus Injury Treatments.
Meniscus Injury Prevention. Stages of Soft Tissue Healing. The application of cold compression is an simple, effective pain minimization treatment for minor meniscus injuries.
Left untreated, meniscus injuries can be extremely debilitating and lead to life long complications. In older people whose menisci what is a bucket handle meniscus tear more likely to be worn down, a tear can result from even a very minor injury.
To heal as fast as possible: Rest Use a cold compression wrap to reduce pain, swelling. Once swelling is reduced and healing has begun, start stretching the injured joint. There are two menisci in each knee joint - the medial meniscus and the lateral meniscus; each of the menisci are "C" shaped and exist to cushion impact between the lower leg bone shinbone and the upper leg bone thighbone.
Medically speaking, the menisci are termed as "fibrocartilage" and are soft and rubber-like in nature. The medial meniscus is found on the inside of each knee joint whereas the lateral meniscus is found on the outside portion of each knee. Your menisci act much like a wedge to help naturally prevent over-rotation in the joint, but just as important, the menisci are the true shock absorbers in the knee joint. When walking, jumping or running, there are heavy forces exerted on the knees; your meniscus absorbs and disperses much of the forces instead of the ends of the bones where the upper leg and lower leg meet in the knee joint.
If the ends of these bones absorb too much force, they will become damaged. It is also worth knowing that the amount of force exerted on the knee joint grows exponentially as speed of what does colloquial language do increases ie. Both the medial and lateral meniscus pads sit on top of the tibia bone lower leg bone and form a concave surface for the rounded ends of the femur bone upper leg bone to rest on.
These menisci act like suction cups to help hold the tibia and femur bones together in the joint. Both lateral and medial menisci are held in place with 'root' attachments at the very posterior aspect of the meniscus back of the knee - this area being known as the "posterior horn". As the name suggests, it roots the tissue in place inside the knee, providing stability and helping prevent the meniscus from being squeezed out of place by the bones of your knee like a toothpaste out a tube.
Both the lateral and medial menisci are also attached at the anterior horn location where it attaches to the tibia via the anterior cruciate ligament ACL which is in the center front of the knee.
The medial meniscus has a third point of attachment at the Medial Collateral Ligament MCL which is found on the medial inner side of the knee. As the medial meniscus has 3 points of attachment, compared to only 2 points for the lateral meniscus, there is less freedom of movement of the medial meniscus in the knee joint. This reduced freedom of movement is one of the primary reasons that the medial meniscus is damaged more often than the lateral meniscus - basically, the medial meniscus is less forgiving.
The shape of your meniscus tear is important because it will help determine the type of treatment you receive ; some tears will heal without surgery, some can be treated surgically and some can't be bluetooth optical mouse how to connect. Tears come in many shapes and sizes, however there are 3 basic shapes for all meniscal tears: longitudinal, horizontal, and radial.
If these tears are not treated, they may become more damaged and develop a displaced tear often referred to as a bucket handle tear longitudinalflap tear horizontal or parrot beak tear radial. Complex tears are a combination of two or more of these basic shapes with damage occurring in more than one direction and depth. A complex meniscal tear is most often experienced in younger people due to a sports related traumatic event. The forces on the knee can become so great that the meniscus is squished and pulled at the same time.
Large, diverse stresses at different stress points can tear the meniscus into more than one tear shape. Often times, when you have such a traumatic injury, you are suffering from MCL or ACL ligament tears at the same time and surgery is needed to both repair what can be repaired and remove some or all of the meniscus if needed.
Natural degeneration of soft tissue in the body is experienced as we age, and this changes the surface of meniscal tissue as well. As we age, the meniscus gets thinner; if we have been hard on our menisci, over time they will wear out with use. Wear and degeneration usually manifests itself in the inner edges of the meniscus starting to fray, as the inner edges are where the meniscus is thinnest. Degenerative changes to the knee happen slowly, so you may eventually suffer a torn lateral meniscus from a simple daily activity - it can happen unexpectedly.
Although you may not have suffered from a previous meniscus injury, you are still at risk for degeneration of your meniscal tissue over time - especially if you have placed frequent repetitive stress on the knee joints over the years.
Past events in your history make a difference on the severity of degeneration. Examples of such events might be:. Weakened meniscal tissue can tear from relatively little to no stress on the tissue. You may not even notice that something has happened to your knee until it becomes worse and you begin to feel continued pain.
The most common type of complex tear is a combination of horizontal and radial tears. Your age will directly influence the cause of your meniscus injury. A degenerative tear would require partial meniscectomy to remove damaged and displaced tissue. A meniscal repair isn't possible to fix degenerative damage because of the jagged and torn nature of the meniscus. A meniscal repair of degenerative tissue would be very difficult to perform and reduces the rate of success for healing.
Because of this fact, your age increases the likelihood that your surgeon will feel that your tear can't be repaired. Anyone can injure their meniscus, though a complex meniscus tear most often occurs due to degeneration of the meniscal tissue. People under the age of 20 almost always suffer complex meniscal tears due to sports activities. As you age, however, the likelihood of your meniscus tear occurring due to a sport activity decreases whereas a degenerative causal factor rises.
A complex meniscus injury can happen from sudden and traumatic accidents. Athletes that play sports where their knee is bent have an increased risk of getting a complex meniscus injury. This includes athletes who participate in sports like volleyball, football, soccer, tennis, basketball, baseball, hockey, weight lifters and racket sports.
Everyone can be affected by degeneration of their meniscus over timeedges of the meniscus become frayed, jagged, thin, and brittle. Any repetitive or frequent movement can place stress on your meniscus over the years. This gradual wear and tear on the knees comes for overuse, repetitive knee movements, twisting or prolonged weight bearing activities. Degenerative changes to what is a bucket handle meniscus tear knee happen slowly, so you may suffer a torn meniscus from a simple daily activity.
You need to be aware that this injury can happen to anyone and happens more often the older you are. It is not just isolated to athletes! If you've suffered a traumatic sudden injury to your knee while playing sports, swelling to your knee will happen within a few hours after the injury or in the following days. Your knee may feel unstable and you may also experience more intense pain when bending, walking, or twisting your knee.
You'll continue to feel some tenderness on the outer part of your knee. You may also find that you are unable to move your knee locking or a damaged meniscus is catching when you flex the joint. Mild, degenerative complex meniscus tears are much more subtle, usually manifesting through knee pain that increases over time.
You may or may not have swelling after exercise or daily activities. If you do have pain, you may possibly feel weakness and instability in your knee. You may feel your knee experiencing mild catching, snapping or clicking when it is being flexed.
As a degenerative complex meniscus tear becomes more severe, you might feel a 'giving-way' sensation instability in your knee and your knee may be more likely to lock up. Pain may increase with certain activities, like climbing a set of stairs, kneeling to do simple things such as putting away groceries or squatting to pick up something you may have dropped. You may develop a 'cyst' bulging out from the back or side your knee.
The cyst may decrease your range of movement and leave you with an inability to stretch out your knee. You may also experience tightness due to swelling and tenderness around your knee. A complex meniscus tear is diagnosed via the same methods that any meniscus tear is diagnosed - by a visit to your doctor for a physical examination of the knee.
Range of motion tests will be done to see how much movement has been lost in the knee. There are many conditions other than meniscus injuries that can cause knee pain such as an ACL tear, patellar or quadriceps tendinitis, a fracture, arthritis or knee bursitis.
Getting a proper diagnosis is important so you can treat your condition correctly. Having said that, if you are experiencing locking or catching in the knee joint, odds are good that there is either meniscus damage or articular cartilage damage or how to do cool longboard tricks. Your doctor may consider previous knee injuries or joint stiffness that you may have had in the past.
This will help the doctor to determine if you have a more complex injury in your knee and rule out any other knee injuries that may be present. A set of range of motion tests will be completed by the doctor including the McMurray's Test how to make homemade body armor, joint line how to do different braid hairstyles and the Ege's test.
Your knee might hurt from the doctor poking and prodding at it, but by doing this the doctor will know what is in diet soda that is harmful sure the source of your pain, the level of tenderness in and around your knee and how well your knee can move with this condition. It's possible for your doctor to think you have a medial meniscus tear if the physical tests and pain present near the opposite side of the knee.
This most commonly happens with posterior lateral meniscus tears. The only way to know for sure where your tear is located and what type of tear you have is through diagnostic testing via an MRI. Even then, if the tear is expected to be on the medial innermost side of the knee, the MRI may not take an image at an angle needed to see the tear on the lateral what to use to cut drywall. There are a variety of different tests available to help them analyze the situation; and the recommendation will be dependent on your injury.
X-rays will provide an image of the overall bone structure of your knee. It's helpful in identifying abnormal bone shapes, fractures, arthritis, or loose bones and bone abnormalities that may mimic a torn meniscus. Other tests like a bone scan, MRI magnetic resonance imaging or blood tests may be done if an x-ray looks normal or the doctor is unsure whether you have a fracture. These tests will also rule out any infections of the bone or tissue and help to determine if you are suffering from other injuries like arthritis or osteoarthritis degenerative damage.
If you are experiencing a build up of fluid in the knee, your doctor may aspirate use a needle to remove fluid from the joint to check for bacterial infection. Your doctor will be able to determine whether there is an infection or not by drawing a small sample of the synovial fluid with a needle. If it is determined that there is an infection, you will be prescribed antibiotics to get rid of the infection and the physician may pursue deeper inspections into determining the source o infection.
Bucket-handle meniscal tears are a type of displaced vertical meniscal tear where the inner part is displaced centrally. They more commonly occur in the medial meniscus and are often associated with anterior cruciate ligament (ACL) tears.. Radiographic features MRI. Bucket-hand tears can manifest as sensitive but not specific signs 1. absent bow tie sign - on sagittal view. Aug 01, · A bucket-handle tear is a longitudinal, full-thickness tear, which is reported to comprise almost 10% of all meniscus tears. 1 This type of tear pattern is commonly seen in younger (meniscus bucket-handle tears frequently. If these tears are not treated, they may become more damaged and develop a displaced tear often referred to as a bucket handle tear (longitudinal), flap tear (horizontal) or parrot beak tear (radial). Complex tears are a combination of two or more of these basic shapes with damage occurring in more than one direction and depth.
Meniscus tears are commonly encountered in the clinical and operative setting and vary in presentation, including bucket-handle, radial, and horizontal cleavage tears. Historically, tears were treated with benign neglect or partial meniscectomy. However, a great deal of subsequent research has highlighted the biomechanical consequences of tears and meniscectomy, including increased peak local contact forces, progressive postmeniscectomy arthritis, and subsequent arthroplasty.
With the advent and evolution of repair devices, increasing attention is being turned to the ideal restorative treatment of meniscus tears. Successful meniscus repair is centered about the ABCs of repair: Anatomic reduction, Biologic preparation and augmentation, and Circumferential compression. Clinical outcomes of meniscus repair using modern techniques have been promising, with reapproximation of native joint biomechanics, substantial improvements in patient subjective outcome scores, and satisfactory reoperation rates.
With implementation of the ABCs of meniscus repair as well as the continued expansion of the orthopedic surgeons' meniscus repair toolbox, restoration and preservation of the meniscus are increasingly possible across the spectrum of tear types. Published by Elsevier Inc. All rights reserved. Abstract Meniscus tears are commonly encountered in the clinical and operative setting and vary in presentation, including bucket-handle, radial, and horizontal cleavage tears.