Objective: The aim of this study was to analyze and compare the preoperative anamnestic details between patients with an arthroscopic diagnosis of bucket handle and other tear patterns of the medialmeniscus in stable knees.Methods: A total of 204 patients (mean age 49.3± 13 years) were included in the study. The mean agewas 49.3± 13 years. The study group included 65 patients (63 males, 2 females) with an arthroscopicdiagnosis of bucket handle tear and the control group included 139 patients (90 males, 49 females) withnon-bucket handle tear patterns. The preoperative clinical assessments of the two groups were analyzedretrospectively. Anamnestic prediction for the diagnosis of a bucket handle tear was based upon variousmedical history parameters. Multivariate logistic regression was carried out to identify independentanamnestic factors for predicting isolated bucket handle tears of the medial meniscus compared to nonbucket handle tears.Results: Analysis of the multivariate logistic regression yielded 3 statistically signiŞcant independentanamnestic risk factors for predicting isolated bucket handle tears of the medial meniscus: male gender(OR, 9.7; 95% CI, 1.1e37.6), locking events (OR, 4.6; 95% CI, 1.8e11.3) and pain in extension (OR, 6.9; 95%CI, 2.5e23.7). Other preoperative variables such as age, BMI, activity level, comorbidities, duration ofsymptoms, pain location, preceding injury and its mechanism had no signiŞcant effect on tear pattern.Conclusions: Preoperative strong clues for bucket handle tears of the medial meniscus in stable knees aremale gender, locking events and limitation in extension.Level of evidence: Level III, Diagnostic study
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1. Bernstein J. In brief: meniscal tears. Clin Orthop Relat Res. 2010;468: 1190e1192.
2. Laible C, Stein DA, Kiridly DN. Meniscal repair. J Am Acad Orthop Surg. 2013 Apr;21(4):204e213.
3. Scholten RJ, Deville WL, Opstelten W, Bijl D, van der Plas CG, Bouter LM. The accuracy of physical diagnostic tests for assessing meniscal lesions of the knee: a meta-analysis. J Fam Pract. 2001;50:938e944.
4. Harrison BK, Abell BE, Gibson TW. The Thessaly test for detection of meniscal tears: validation of a new physical examination technique for primary care medicine. Clin J Sport Med. 2009;19:9e12.
5. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis. 1957;16:494e502.
6. Briggs KK, Kocher MS, Rodkey WG, Steadman JR. Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Jt Surg Am. 2006;88:698e705.
7. Daniel D, Daniels E, Aronson D. The diagnosis of meniscus pathology. Clin Orthop Relat Res. 1982 Mar;163:218e224.
8. Fowler PJ, Lubliner JA. The predictive value of five clinical signs in the evaluation of meniscal pathology. Arthroscopy. 1989;5(3):184e186.
9. Miller RH, Azar FM. Knee injuries. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. Philadelphia: Elsvier; 2012.
10. Boeree NR, Ackroyd CE. Assessment of the menisci and cruciate ligaments: an audit of clinical practice. Injury. 1991;22:291e294.
11. Miller GK. A prospective study comparing the accuracy of the clinical diagnosis of meniscus tear with magnetic resonance imaging and its effect on clinical outcome. Arthroscopy. 1996;12:406e413.
12. Abdon P, Lindstrand A, Thorngren KG. Statistical evaluation of the diagnostic criteria for meniscal tears. Int Orthop. 1990;14:341e345.
13. Corea JR, Moussa M, al Othman A. McMurray's test tested. Knee Surg Sports Traumatol Arthrosc. 1994;2:70e72.
14. Metcalf MH, Barrett GR. Prospective evaluation of 1485 meniscal tear patterns in patients with stable knees. Am J Sports Med. 2004;32:675e680.
15. Dervin GF, Stiell IG, Wells GA, Rody K, Grabowski J. Physicians' accuracy and interrator reliability for the diagnosis of unstable meniscal tears in patients having osteoarthritis of the knee. Can J Surg. 2001 Aug;44(4):267e274.
16. Yan R, Wang H, Yang Z, Ji ZH, Guo YM. Predicted probability of meniscus tears: comparing history and physical examination with MRI. Swiss Med Wkly. 2011 Dec;141:w13314.
17. Snoeker BA, Zwinderman AH, Lucas C, Lindeboom R. A clinical prediction rule for meniscal tears in primary care: development and internal validation using a multicentre study. Br J Gen Pract. 2015 Aug;65(637):e523ee529.
18. Feucht MJ, Bigdon S, Bode G, et al. Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns. J Orthop Surg Res. 2015 Mar 18;10:34.