Evaluation of the Clinical Outcomes and Cost-Effectiveness of A Novel Arthroscopic Sequential Repair Technique for Bucket Handle Meniscal Tears

Background: Bucket handle meniscal tears (BHTs) are large, displaced vertical longitudinal tears that challenge meniscal preservation. All-inside repairs using multiple devices are effective but increase cost. This study evaluates a cost-effective technique using a single all-inside device to place 7 continuous sequential stitches for circumferential compression and tear stability.

Methods: A prospective study was conducted on 150 patients (ages 18–45) with isolated medial or lateral BHTs. All underwent arthroscopic repair using only one all-inside meniscal repair device, with 7 sequential locking stitches placed from posterior to anterior. Clinical outcomes were assessed with Lysholm, IKDC, and VAS scores preoperatively and at 3, 6, and 12 months. MRI was done at 6 months.

Results: Mean Lysholm score improved from 51.6 ± 9.1 to 90.3 ± 5.7. IKDC scores improved from 47.8 ± 6.9 to 85.9 ± 6.0. VAS scores reduced from 7.1 ± 1.2 to 1.5 ± 1.0. MRI showed 93.3% healing rate. No re-tears or neurovascular complications occurred. The use of a single device significantly reduced implant cost without compromising outcome.

Conclusion: Arthroscopic repair of BHTs with 7 sequential stitches using a single all-inside device is safe, cost-effective, and clinically effective