Semimembranosus Tendon‐Sparing Arthroscopic Inside‐Out Repair of a Medial Meniscus Bucket‐Handle Tear

Bucket‐handle tears of the medial meniscus are a common knee injury. Meniscal repair restores stability, reduces degenerative changes, and improves clinical outcomes. Repair may be performed using all‐inside, outside‐in, or inside‐out techniques. Among these, the inside‐out technique is widely regarded as the gold standard because of its reliability and broad applicability. However, blind needle passage during inside‐out repair carries a risk of semimembranosus tendon entrapment. The purpose of this technical note is to describe a step‐by‐step surgical technique for inside‐out repair of medial meniscus bucket‐handle tears that recognizes and addresses entrapment of the semimembranosus tendon.