Logan CA, et al. - Comparison of outcomes an inside-out repair vs meniscectomy of a medial meniscus bucket-handle tear in restoring native contact areas and pressures across the tibial plateaus was performed in the setting of an anterior cruciate ligament (ACL) reconstruction (ACLR). Researchers tested 10 fresh-frozen cadaveric knees in 6 knee conditions (1: intact; 2: ACL torn and bucket-handle tear of medial meniscus, flipped; 3: bucket-handle tear of medial meniscus, reduced; 4: bucket-handle tear of medial meniscus, repaired via inside-out vertical mattress suture technique; 5: ACLR with bone patella tendon bone autograft and bucket-handle repair; 6: ACLR and medial meniscus bucket-handle tear debridement) at 4 flexion angles (0°, 30°, 45°, and 60°), under a 1,000-N axial load. Using Tekscan sensors, they assessed contact area and pressure. Outcomes revealed significant increases in mean and peak contact pressures in not only the medial but also the lateral compartment when resection of a bucket-handle medial meniscus tear concurrent with an ACLR was performed. To more closely restore native tibiofemoral biomechanics, they emphasize preservation of the medial meniscus in the face of a bucket-handle tear as essential.