Acute Anterior Cruciate Ligament Injury with Medial and Lateral Bucket-Handle Meniscus Tears

A meniscus tear is a very common secondary injury seen in patients who have anterior cruciate ligament (ACL) ruptures. The lateral meniscus is more commonly injured in the setting of an acute ACL tear.1–3One type of injury that is infrequently seen with ACL injuries is the bucket-handle meniscal tear (BHMT). A BHMT is a vertical or oblique longitudinal tear with an attached fragment displaced away from the periphery of the meniscus.4,5 BHMTs are quite rare and account for only 10 % of all the meniscal lesions.4,5 The mechanism of BHMTs in the setting of ACL injuries can vary.6 For lateral BHMTs, the posterior aspect of the lateral meniscus typically gets trapped between the rotational impaction of the midportion of the lateral femoral condyle and posterior lateral tibial plateau (typical bone bruise pattern). As the knee reduces, the loose attachments of the posterio