Bucket Handle Meniscus Tears

Meniscus tears are a common injury to the knee and cause pain, swelling, and limited mobility. One of the most serious types of meniscus tears is called a bucket-handle meniscus tear. Most people are never aware they have a meniscus. That is—until they injure their meniscus.

Cropped view of patient leg at hospital
Volker Schlichting / EyeEm / Getty Images


The meniscus is a type of cartilage in the knee joint. In each knee, there are two menisci, one on the inner side of the knee (medial meniscus), and one on the outer side of the knee (lateral meniscus). The meniscus functions to help distribute force across the joint and is important in cushioning and protecting the cartilage of the knee. 

A bucket handle tear of the meniscus occurs on the outer portion of the meniscus cartilage and causes a vertical slice through the meniscus. The attachments of the meniscus remain intact, and the torn portion of the meniscus pulls into the center of the joint.

A bucket-handle tear gets its name because the torn segment of the meniscus pulls away forming a handle shaped segment of damaged meniscus tissue.


Symptoms of a bucket handle tear are similar to a typical meniscus tear. However, it also typically causes a locked knee joint. A locked knee occurs when the knee cannot fully straighten from a bent position. Because the bucket handle fragment of meniscus cartilage is displaced into the front of the joint, it prevents the knee from fully straightening.


Most often, a skilled examiner can determine if a meniscus tear is likely by examining your knee. Often an MRI is performed to determine the type and location of the meniscus tear. Bucket handle tears are clearly visible on MRIs, and often show the classic 'double PCL' sign where the meniscus fragment rests alongside the posterior cruciate ligament (PCL) causing the ligament to look duplicated.

Bucket handle meniscus tears are often associated with an anterior cruciate ligament injury (ACL tear). In this common sports injury, one of the major knee ligaments is damaged, and at the same time, the bucket handle meniscus tear occurs. 

Treatment Options

The usual treatment is with arthroscopic knee surgery. While sometimes your healthcare provider can manipulate the tear into proper position, surgery is still needed to address the damage. Surgery is not an emergency but should be performed as soon as possible so that the knee can bend and straighten normally. There are two options for how to manage the torn meniscus:

  • Meniscectomy Partial: This is a surgery performed to remove the damaged portion of the meniscus. The torn meniscus is removed from the joint causing the remaining meniscus to be smaller than normal. If there is little healing potential of the meniscus, this is the best treatment. One advantage of removing the torn meniscus is that the recovery is much faster with most athletes returning to sports activities within 6 weeks.
  • Meniscus Repair: A meniscus repair is performed to sew together the torn part of the meniscus back in its proper position. This procedure is only possible when there is a good blood supply to the area of damage to allow for healing of the tear. Healing of the meniscus repair requires a much longer rehabilitation that often requires 4 months or longer to return to sports activities.

Following surgery, most patients will undergo physical therapy and rehabilitation to regain lost mobility of the joint and strength in the extremity. The duration of rehab following surgery will depend on a number of factors including the treatment chosen. There are possible complications of arthroscopic surgery on the knee joint. While these are uncommon, there are steps you can do to ensure the best outcome possible.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Wright J, Tamura C, Findlay I, Daneshfar A. Simultaneous bicompartmental bucket handle meniscal tears with a clinically competent Anterior Cruciate Ligament. J Orthop Surg Res. 2010;5:68. doi:10.1186/1749-799X-5-68

  3. Frizziero A, Ferrari R, Giannotti E, Ferroni C, Poli P, Masiero S. The meniscus tear: State of the art of rehabilitation protocols related to surgical procedures. Muscles Ligaments Tendons J. 2012;2(4):295-301.

  4. Yoon KH, Park KH. Meniscal repair. Knee Surg Relat Res. 2014;26(2):68-76. doi:10.5792/ksrr.2014.26.2.68

  5. Encinas-ullán CA, Rodríguez-merchán EC. Arthroscopic treatment of total knee arthroplasty complications. EFORT Open Rev. 2019;4(2):33-43. doi:10.1302/2058-5241.4.180035

Additional Reading

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.