Intra-articular patterns of bucket handle meniscal tears and its relation to reducibility

Hong Chul Lim, Ji Hoon Bae, Taik Sun Kim, Jae Hyuk Yang, Sung Chul Park, Jung Ro Yoon

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The purpose of this study was to assess the intra-articular patterns in the rotational deformities of bucket handle meniscal tears (BHMTs) based on arthroscopic findings and their clinical relevance. Methods: From 2004 to 2009, 42 patients with a BHMT diagnosed by magnetic resonance imaging underwent arthroscopic surgery. The arthroscopic data (all procedures were recorded) were evaluated retrospectively, and BHMTs were classified according to the rotational directions of centrally displaced fragments. To assess the reliability of the agreement in this classification, 2 orthopedic surgeons re-classified BHMTs, 1 week after first trial. Intra- and interobserver reliabilities were assessed using kappa statistics. In addition, we address specific tear patterns, associated anterior cruciate ligament injury, medio-lateral difference, reducibility, chronicity, and reparability. Results: Most of the tears could be categorized into one of 3 morphologic patterns. Of the tears, 4.8% could not be categorized. BHMTs were classified, based on the rotational directions of centrally displaced fragments, as follows; the upward rotation group (type 1), the downward rotation group (type 2) and the reverse group (type 3). The most common intra-articular pattern was type 1 (29 patients, 69%). The occurrence of the other patterns was: type 2 in 7 patients (16.7%), type 3 in 4 patients (9.5%); we were not able to make a classification of type in 2 patients (4.8%). Intra-observer reliability was 0.86 in terms of kappa statistics, which implies almost perfect agreement. Mean interobserver reliability (0.73) showed substantial agreement. Type 1 and 2 tears were easily reduced, whereas all type 3 tears (4/4) needed additional procedures to achieve reduction. Conclusions: Based on arthroscopic findings, we describe a comprehensive BHMT classification scheme that encompasses 95.2% of all tears. Tear type was correlated with reducibility.

Original languageEnglish
Pages (from-to)129-133
Number of pages5
JournalClinics in Orthopedic Surgery
Volume4
Issue number2
DOIs
Publication statusPublished - 2012 Jun 25
Externally publishedYes

Fingerprint

Tears
Joints
Arthroscopy
Tibial Meniscus Injuries
Magnetic Resonance Imaging

Keywords

  • Arthroscopy
  • Bucket handle meniscal tear
  • Intra-articular pattern
  • Knee
  • Menisci

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Intra-articular patterns of bucket handle meniscal tears and its relation to reducibility. / Lim, Hong Chul; Bae, Ji Hoon; Kim, Taik Sun; Yang, Jae Hyuk; Park, Sung Chul; Yoon, Jung Ro.

In: Clinics in Orthopedic Surgery, Vol. 4, No. 2, 25.06.2012, p. 129-133.

Research output: Contribution to journalArticle

Lim, Hong Chul ; Bae, Ji Hoon ; Kim, Taik Sun ; Yang, Jae Hyuk ; Park, Sung Chul ; Yoon, Jung Ro. / Intra-articular patterns of bucket handle meniscal tears and its relation to reducibility. In: Clinics in Orthopedic Surgery. 2012 ; Vol. 4, No. 2. pp. 129-133.
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abstract = "Background: The purpose of this study was to assess the intra-articular patterns in the rotational deformities of bucket handle meniscal tears (BHMTs) based on arthroscopic findings and their clinical relevance. Methods: From 2004 to 2009, 42 patients with a BHMT diagnosed by magnetic resonance imaging underwent arthroscopic surgery. The arthroscopic data (all procedures were recorded) were evaluated retrospectively, and BHMTs were classified according to the rotational directions of centrally displaced fragments. To assess the reliability of the agreement in this classification, 2 orthopedic surgeons re-classified BHMTs, 1 week after first trial. Intra- and interobserver reliabilities were assessed using kappa statistics. In addition, we address specific tear patterns, associated anterior cruciate ligament injury, medio-lateral difference, reducibility, chronicity, and reparability. Results: Most of the tears could be categorized into one of 3 morphologic patterns. Of the tears, 4.8{\%} could not be categorized. BHMTs were classified, based on the rotational directions of centrally displaced fragments, as follows; the upward rotation group (type 1), the downward rotation group (type 2) and the reverse group (type 3). The most common intra-articular pattern was type 1 (29 patients, 69{\%}). The occurrence of the other patterns was: type 2 in 7 patients (16.7{\%}), type 3 in 4 patients (9.5{\%}); we were not able to make a classification of type in 2 patients (4.8{\%}). Intra-observer reliability was 0.86 in terms of kappa statistics, which implies almost perfect agreement. Mean interobserver reliability (0.73) showed substantial agreement. Type 1 and 2 tears were easily reduced, whereas all type 3 tears (4/4) needed additional procedures to achieve reduction. Conclusions: Based on arthroscopic findings, we describe a comprehensive BHMT classification scheme that encompasses 95.2{\%} of all tears. Tear type was correlated with reducibility.",
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