Spontaneous healing of bucket handle tear of the medial meniscus associated with ACL tear

Abstract

We report a case of injury of the medial bucket handle meniscal tears (BH), which resolved spontaneously, in association with anterior cruciate ligament (ACL) injury. The patient twisted his left knee during a fight in martial arts, progressing to pain and joint locking and a sense of distortion. In NMR it could be seen bucket-handle tear of the medial meniscus with displacement of the fragment to the intercondylar region, rupture of the lateral meniscus and ACL tear. After conservative treatment and physiotherapy, in an interval of one year, later examinations showed that there was spontaneous healing of AB.

Nonsurgical Resolution of a Bucket Handle Meniscal Tear: A Case Report

“…The evidence of spontaneously healed BHMTs in 4 other patients suggests that this patient's BHMT may have healed spontaneously after reduction of the displaced fragment, without any treatment with PRP [5‐8]. PRP is concentrated autologous platelets that are injected directly to the point of degeneration or trauma, and some evidence indicates that PRP might be used to stimulate human chondrocyte proliferation and improve healing of the peripheral meniscus [10,11].…”

“…The standard of care is the surgical inside‐out suture repair technique, which may cause injury to the saphenous nerve, peroneal nerve, or popliteal vasculature [4]. Four case reports have described spontaneous resolution of BHMTs, with 2 cases in patients who were 17 and 23 years old with anterior cruciate ligament (ACL)‐deficient knees and 2 cases in an 11‐year‐old and a 71‐year‐old with intact ACLs [5‐8].…”

Spontaneous Healing of a Posteriorly Displaced Lateral Meniscus Bucket-Handle Tear in a Multiligament Knee Injury

“…BHMTs are generally considered unstable tears with poor healing capabilities 27,31 . However, BHMTs have demonstrated rare spontaneous healing when the displaced fragment has been reduced [12][13][14]32,33 . In our case, the BHMT was in the peripheral vascular territory (red-red zone), which has demonstrated the greatest capacity for meniscal healing 8 .…”

“…The meniscus is a relatively avascular structure but has shown healing potential with tears that extend into the middle onethird avascular zone [8][9][10][11] . In a few rare instances, BHMTs have healed spontaneously and have occurred primarily in younger patients with isolated tears or concomitant ACL injury [12][13][14] . However, we are unaware of a report of spontaneous healing of a BHMT in patients who sustained MLKIs.…”