Bucket-handle meniscal tears classically present with which symptom, and what is the typical management?

• A. Knee pain with swelling but no locking
• B. Gradual dull knee pain
• C. No swelling and minimal functional impairment
• D. Bucket-handle tear presents with knee locking or catching; treated with arthroscopic repair or partial meniscectomy depending on pattern and patient factors

Answer: (D)

Bucket-handle tears cause a mechanical problem in the knee because the torn inner portion can flip into the joint, leading to knee locking or catching. That locking is the classic clue that the tear is displaced and causing a block to motion. Because the issue is a displaced piece of meniscus, the typical management is surgical, usually via arthroscopy to reduce the fragment and address the tear. If the tear is in the peripheral, vascularized region and the tissue is suitable, repairing it preserves meniscal tissue and function. If the tear isn’t amenable to repair due to location, tissue quality, or patient factors, a partial meniscectomy to remove the torn portion and smooth the edge is performed. The exact plan depends on the tear pattern, tissue quality, and patient factors such as age and activity level.