PurposeOutcomes after repair of bucket‐handle meniscal tears tend to be satisfying in the short‐term follow‐up. However, the literature is scarce regarding long‐term data following repair of bucket‐handle meniscal tears. The aim of this study was to assess long‐term follow‐up outcomes, focusing on knee osteoarthritis (OA) development and failure rate, and determine risk factors associated with failure. MethodsThis is a retrospective cohort study, including all patients with bucket‐handle tears within 4 mm of the menisco‐synovial junction, who underwent meniscal repair, either isolated or combined with anterior cruciate ligament reconstruction (ACLR) between 2004 and 2015. A combination of all‐inside, outside‐in, and inside‐out repair technique was used in all patients. Patients over 40 years old, concomitant multi‐ligamentous injuries, and severe cartilage lesions documented intraoperatively were excluded. During the follow‐up, a meniscus was considered healed using Barrett’s criteria, while knee OA evaluation was performed according to Kellgren–Lawrence (KL) classification using standing knee radiographs. Patients were assessed preoperatively as well as postoperatively in terms of knee function using International Knee Documentation Committee (IKDC) score, Lysholm score, and Knee injury and Osteoarthritis Outcome Score (KOOS). ResultsIn total, the inclusion criteria were met by 66 patients. Median age at the time of operation was 21.9 years (13–39). Median follow‐up was 114 (62–176) months. Total failure rate was approximately 33% at median time of 19 (6–39) months. Osteoarthritis was statistically significantly more prevalent in patients with failed repairs (mean KL score: 2.09) in comparison to patients with successful repairs (mean KL score: 0.54) p = 0.001. In addition, successful repairs were associated with higher KOOS score as compared with failed repairs (mean ± SD, 89.6 ± 4.6 vs 77.8 ± 4.9 p < 0.001), higher IKDC score (mean ± SD, 88.2 ± 5.1 vs 79.2 ± 5.2 p < 0.001), and Lysholm score (mean ± SD, 90.3 ± 5.3 vs 78.4 ± 7.8 p < 0.001). Patients with medial meniscus repair had 4.8 higher relative likelihood of failure compared to lateral meniscus [p = 0. 014, OR = 4.8 (95% Cl 1.2, 18.6)]. Patients over 16 years old had 5.7 higher relative likelihood of failure [p = 0. 016, OR = 5.7 (95% Cl 0.04, 0.85)]. Concurrent ACLR did not have a significant effect on the postoperative outcomes. ConclusionA high rate of clinical failure was observed after meniscal repair of bucket‐handle tears. However, successful treatment led to lower rates of knee OA development and better knee function, approximately 10 years postoperatively. Meniscal repair of bucket‐handle tears is recommended to improve knee function and prevent knee OA in young patients. Level of evidenceIII.

A 26-year-old male athlete presented to our hospital with bilateral leg pain after intense training. He had a history of transient numbness and pain with rigorous exercise but this time pain persisted and drop foot developed. Unfortunately, the diagnosis of acute exertional compartment syndrome was delayed due to late presentation of the patient in our department. He underwent three consecutive surgeries for decompression and debridement. At 13 months follow-up, he is ambulatory with bilateral ankle-foot orthosis. This case presents a bilateral, acute anterior exertional compartment syndrome of the leg and highlights the need for high clinical suspicion and early treatment of the acute exertional compartment syndrome.

Osteochondromas are the most common benign bone tumor; nonetheless, the natural history is poorly understood as a result of the low threshold for resection and the fact that many of these lesions are asymptomatic and therefore never diagnosed. We present a case of a 17-year-old patient whose routine shoulder X-ray evaluation, due to a minor shoulder injury, revealed spontaneous regression of a previously documented left proximal humerus osteochondroma at six years follow-up. The likelihood of spontaneous regression should be better understood by orthopedic surgeons and taken into account in the decision process of whether to remove osteochondromas surgically or wait.