{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T12:39:41Z","timestamp":1782477581891,"version":"3.54.5"},"reference-count":36,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Bucket-handle meniscal tears (BHMTs), which we define as vertical longitudinal tears of the meniscus with displacement of the torn inner fragment toward the intercondylar notch region, are a well-recognized tear pattern. Optimizing the management of BHMTs in younger patients is important, as preserving meniscal tissue may limit future joint degeneration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose\/Hypothesis:<\/jats:title>\n                    <jats:p>The purpose of this study was to review the patient demographics, clinical presentation, operative details, outcomes, and risk factors for a reoperation associated with operatively treated BHMTs in a pediatric population. We hypothesized that the repair of BHMTs in adolescents would yield a higher reoperation rate than meniscectomy in our population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Case-series; Level of evidence, 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A departmental database was queried to identify all patients 19 years or younger who presented with a BHMT and underwent surgery between October 2002 and February 2013. Clinical, radiological, and surgical data were retrospectively collected, and risk factors for a reoperation and persistent pain were assessed in all patients with longer than or equal to 6 months of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 280 BHMTs were treated arthroscopically by 1 of 8 sports medicine fellowship\u2013trained surgeons. The mean age at surgery was 15.5 \u00b1 2.5 years (range, 2.1-19.2 years), and most patients were male (177\/280; 63%). Most injuries occurred during sports (203\/248; 82%) and involved the medial meniscus (157\/280; 56%). Concurrent anterior cruciate ligament (ACL) surgery was performed in 103 cases (37%). Meniscal repair was performed in 181 cases (65%) and was more common in younger patients ( P = .01) and for the lateral meniscus ( P &lt; .001). Among 185 (66%) cases with longer than or equal to 6 months of adequate follow-up data (which included 126 meniscal repairs [68%]), a meniscus-related reoperation occurred in 45 (24%) cases. A reoperation related to the original BHMT injury or surgery was more common after meniscal repair than after meniscectomy (40\/126 [32%] vs 5\/59 [8%], respectively) ( P = .001) and less common with concurrent ACL surgery ( P = .07), although this was not statistically significant. Among patients injured during sports and with adequate follow-up, all but 1 patient (176\/177; 99%) returned to sports; a slower rate of return was seen in those undergoing meniscal repair ( P = .002) and concurrent ACL surgery ( P &lt; .001). At final follow-up, 170 of 185 patients (92%) were pain free. For the 15 patients with persistent pain at final follow-up, no identifiable risk factors for persistent pain were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Most BHMTs in younger patients occurred in males and during sports and affected the medial meniscus. Concurrent ACL surgery was indicated in approximately one-third of cases and was associated with a lower reoperation rate and slower return to sports. Two-thirds of patients underwent meniscal repair, over two-thirds of whom did not require a reoperation during the study period, despite the high activity levels in this age group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2325967118820305","type":"journal-article","created":{"date-parts":[[2019,1,15]],"date-time":"2019-01-15T04:01:22Z","timestamp":1547524882000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Outcomes After the Operative Treatment of Bucket-Handle Meniscal Tears in Children and Adolescents"],"prefix":"10.1177","volume":"7","author":[{"given":"Dennis E.","family":"Kramer","sequence":"first","affiliation":[{"name":"Division of Sports Medicine, Department of Orthopedic Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie 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Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyle J.","family":"Micheli","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine, Department of Orthopedic Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benton E.","family":"Heyworth","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine, Department of Orthopedic Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts, 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