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20. Bucket Handle Tear Reduction and Repair by a Locally Customized Outside-in Technique; A Simple, Cost-Effective Approach
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Original Article |
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Bucket Handle Tear Reduction and Repair |
Bucket Handle Tear Reduction and Repair by a Locally Customized Outside-in Technique; A Simple, Cost-Effective Approach
Javed Iqbal, Shams U Rehman and Naeem Ullah
ABSTRACT
Objective: Financial restraints are one of the factors that affect repair of the bucket handle tear, as this surgery needs more costly implants and so repair is impractical in limited resources parts of the globe. Therefor the default treatment of bucket handle tear is meniscectomy. A simple, cost effective and reproducible technique has been develop in such scenario. We sought to evaluate the effectives of this technique for bucket handle tear
Study Design: A Prospective study.
Place and Duration of Study: This study was conducted at the Department of Orthopaedic, Traumatology and Sports medicine, MTI, LRH from January 2023 to January 2024.
Methods: A total of 26 patients included in this study & followed for 12 months Bucket handle tear was first reduced and then stabilized by outside in technique, and then the posterior horn was repaired by all-inside meniscus repair device. stability was assessed per operatively by probing the repaired part and success was assessed by patients’ symptoms, Barrett et al criteria and return to their routine activities and sports.Pre surgery, post-surgery and final follow up PROMS were recorded using IKDC & Tegner Lysholum scores.
Results: A total of 26 patients of both genders with mean age of 32.3 years were included in this study. 24(92%) patients were male and 2 (8%) patients were female. Associated ACL injury was in 3 cases (7%), Road traffic accident was the most common cause. During surgery, successful reduction and repair was achieved in 25 patients (96%), while reduction failed in one case (3%)Using Barrett et al criteria, healing was achieved in 24patients (96%), while 1 (4%) patient had recurrence of tear. Repair was planned but that patient lost for further treatment. Our treatment modality was much cheaper that commercially available treatment; average cost of this Outside -in implants was RS 600 to RS 1500, and the average cost of commercially available implant was Rs 18000 to Rs. 25000.IKDC, Tegner Lysholum scores showed a statistically significant improvement at each follow up in all patients
Conclusion: This study concluded that this customized Outside-In technique is simple, reproducible, cost effective, technique leading to satisfactory healing rate and excellent functional outcomes.
Key Words: Bucket handle tear, meniscus tear, meniscus repair, Outside-In meniscus, meniscectomy