Poster 244: A Retrospective Analysis of Bucket Handle Meniscus Tear Repair Outcomes

OBJECTIVES: Bucket handle meniscal tears are a challenging clinical entity with a failure rate as high as 34.5%, which is in stark contrast from the estimated 5% for more simple tear patterns. There are limited data on patient or surgical factors that affect failure. The purpose of this study is to characterize patient and surgical variables that impact two main outcomes: return to sport and revision surgery following surgical repair for bucket handle meniscus tears. METHODS: A retrospective review of all meniscus repairs from 1/1/11 to 1/1/21 was performed for a single institution, and all bucket handle meniscus repairs were included in the study. Demographic information was collected along with injury characteristics and surgical techniques. Outcomes included return to sport and need for revision surgery. Patients with more than 50% of data missing for the variables of interest were removed from the study. Patients without follow-up notes were excluded from return to sport analysis. Failure rate was defined by either a documented re-tear of the former bucket handle meniscus or a revision surgery. RESULTS: There were 205 patients included in the final analysis, with an average of age of 24.42 and 76.39% male, with an average follow-up time of 12.52 months. Demographic and clinical characteristics are summarized in Table 1. Operative characteristics are summarized in Table 2. Of the 117 patients that played sports with available follow-up data, 90 (76.9%) returned to sport and 27 did not (23.1%) with an average follow-up time of 15.01 months. Average return to sport time was 7.21 months +/- 3.77 months. Twelve (13.8%) patients that returned to sport and 12 (44.4%) of the patients who did not underwent future meniscectomy or revision repair surgery. Overall failure rate was 19.0%. The rate of failure of combined all-inside and outside-in technique (33.33%) was higher than rate of failure in all-inside technique alone (14.17%). In a bivariate analysis of risk factors for failure, the variables for age, sex, smoking, BMI, ASA classification, mechanism of injury, and symptom duration before surgery were not found to be statistically significantly different between patients who failed and did not fail repair. CONCLUSIONS: The overall return to sport rate after bucket handle meniscus tear repair in this study was found to be 76.9 with an average return to sport time of 7.21 months. The overall failure rate was found to be 19.0% with an average follow-up time of 12.52 months. Further studies are needed to better understand outcomes following bucket handle meniscus repairs.