Understanding recovery after surgery for a bucket-handle meniscus tear

Daniel Hidalgo
4 days ago
3 min read

A bucket-handle tear is a type of meniscus tear in which a fragment of cartilage is displaced toward the center of the knee joint, potentially locking movement and causing intense pain. It is an extensive longitudinal tear that produces an unstable fragment called a bucket-handle tear. It is more common in the medial meniscus of the knee, but can also occur in the lateral meniscus. Learn more about the knee menisci here.

Bucket handle tear of the medial meniscus — Model demonstrating a bucket-handle tear of the medial meniscus of the knee.

Surgical treatment is indicated in most cases and can be performed in two main ways: partial meniscectomy, which is the removal of part of the meniscus, or meniscal repair, which is proceeded through meniscal suture.

Recovery varies considerably depending on the type of procedure performed.

Rehabilitation after partial meniscectomy

In a partial meniscectomy, only the damaged fragment, or bucket-handle fragment, is removed, preserving as much of the healthy meniscus as possible. Recovery tends to be faster because there are no major restrictions after surgery.

Recovery stages

First weeks: The patient is instructed to put weight on the foot as soon as possible, as tolerated, and to start physiotherapy early, often even before hospital discharge.
Between 2 and 4 weeks: Joint effusion (swelling) reduces, and the patient is able to perform wider movements with the knee.
Between 4 and 6 weeks: Return to light impact activities (cycling, walking) is permitted.
Between 6 and 8 weeks: Many patients are already able to return to sports, depending on individual progress and the type of activity.

Rehabilitation after meniscal repair (meniscal suture)

In meniscus repair, the meniscus is repaired using sutures that allow it to heal in the correct position. This type of surgery preserves the function of the meniscus, but requires more careful and prolonged rehabilitation.

Recovery stages

First weeks: The patient is usually instructed to put weight on the operated knee as much as possible, using crutches if necessary.
First 4 to 6 weeks: Knee flexion is usually restricted, typically limited to 90 degrees, to protect the meniscus sutures.
Between 6 and 12 weeks: The patient is allowed to progressively increase the angles of knee flexion and optimize muscle strength gain.
From 3 months onwards: The patient resumes more intense functional activities, still under physiotherapy guidance.
Between 4 and 5 months: Full return to sports is possible, provided healing is complete.

In this topic, an important observation is warranted: the best people to advise on what should be done after surgery are the doctor who performed the procedure and the physiotherapist who is working on rehabilitation. Several aspects that influence post-operative restrictions should be considered in cases of meniscus repair, such as the type of injury, whether there are associated injuries, among others. Therefore, always follow the instructions of your doctor and physiotherapist, but especially after surgery.

The importance of physiotherapy

Regardless of the type of surgery, physiotherapy is fundamental to restoring range of motion, strength, and stability to the knee, as well as preventing recurrence and other injuries.

Discussion between the doctor and physiotherapist is also of great value after the procedure so that any possible restrictions are taken into account and the patient has the best possible outcome after the injury.