Will my bucket-handle tear be repaired or removed during surgery?

What the operation involves

The surgery is done by arthroscopy through small incisions at the front of the knee, usually under general or spinal anaesthesia. The surgeon first guides the displaced strip back into its normal position. The torn edges are freshened to encourage healing, then stitched with all-inside devices, sutures passed from inside to outside, or a combination, depending on where the tear lies.

Most patients go home the same day or the next morning.

What favours repair

• A recent tear, ideally weeks rather than many months old
• A tear in the outer part of the meniscus, which has a blood supply
• Good-quality tissue without heavy fraying
• A younger, active patient
• Reconstruction of a torn ACL at the same time, which seems to support meniscal healing and protects the repair

When removal is more sensible

If the strip is shredded, has torn into several pieces or lies mostly in the inner zone with little blood supply, stitches are unlikely to hold. Then only the unstable portion is trimmed, keeping as much healthy meniscus as possible. Recovery is quicker, but the knee has less cushioning long term, which is why repair is preferred when it is realistic.

Agreeing the plan beforehand

The MRI gives a good idea, but the final decision is made when the tissue is seen. Before surgery, Dr. Gelber discusses both possibilities so you know what recovery to plan for, including time off work and help at home in Doha. You will be told afterwards exactly what was done.