Bilateral Bucket-Handle Meniscal Tear: A Systematic Review

Featured Application This systematic review summarizes the clinical presentation, imaging findings, and management options for bilateral bucket-handle meniscal tears, supporting earlier recognition and timely referral for arthroscopic treatment to preserve meniscal tissue and optimize functional recovery.Abstract Background: Bucket-handle meniscal tears are a relatively frequent type of meniscal injury; however, the occurrence of bilateral bucket-handle tears is infrequent and poorly described in the literature. This study aimed to systematically review the available evidence and summarize the clinical characteristics, surgical management, and outcomes of bilateral bucket-handle meniscal tears. Materials and Methods: A systematic literature search was conducted in accordance with the PRISMA guidelines using PubMed, Scopus, Google Scholar, and Web of Science databases. Studies reporting bilateral bucket-handle meniscal tears in adult patients were included. Only published clinical cases were analyzed. Results: Four studies were included in the review, comprising a total of five patients and ten affected knees. Most patients were young adults, predominantly male, presenting with knee pain and mechanical symptoms such as locking. Surgical treatment consisted of arthroscopic management, including partial meniscectomy or meniscal repair using all-inside or inside-out techniques. Short- to mid-term follow-up demonstrated satisfactory clinical outcomes in all reported cases, with restoration of knee function and no major complications. Conclusions: Bilateral bucket-handle meniscal tears represent a rare but clinically significant condition. Reported arthroscopic treatments, including meniscal repair and partial meniscectomy, were associated with favorable short- to mid-term outcomes in isolated case reports; however, the available evidence remains anecdotal and insufficient to support definitive treatment recommendations.