University of Kentucky, Lexington, KY.
J Athl Train. 2001 Apr;36(2):160-9.
To review basic meniscal anatomy, histology, and biomechanical principles as they apply to surgery and rehabilitation.
We searched MEDLINE and CINAHL for the years 1960-1999 using the terms meniscus,surgery,rehabilitation,meniscal repair, and arthroscopy.
Injuries to a healthy meniscus are usually produced by a compressive force coupled with transverse-plane tibiofemoral rotation as the knee moves from flexion to extension during rapid cutting or pivoting. The goal of meniscal surgery is to restore a functional meniscus to prevent the development of degenerative osteoarthritis in the involved knee. The goal of rehabilitation is to restore patient function based on individual needs, considering the type of surgical procedure, which meniscus was repaired, the presence of coexisting knee pathology (particularly ligamentous laxity or articular cartilage degeneration), the type of meniscal tear, the patient's age, preoperative knee status (including time between injury and surgery), decreased range of motion or strength, and the patient's athletic expectations and motivations. Progressive weight bearing and joint stress are necessary to enhance the functionality of the meniscal repair; however, excessive shear forces may be disruptive. Prolonged knee immobilization after surgery can result in the rapid development of muscular atrophy and greater delays in functional recovery.
CONCLUSIONS/RECOMMENDATIONS: Accelerated joint mobility and weight-bearing components of rehabilitation protocols represent the confidence placed in innovative surgical fixation methods. After wound healing, an aquatic therapy environment may be ideal during all phases of rehabilitation after meniscal surgery (regardless of the exact procedure), providing the advantages of controlled weight bearing and mobility progressions. Well-designed, controlled, longitudinal outcome studies for patients who have undergone meniscectomy, meniscal repair, or meniscal reconstruction are lacking.
回顾半月板的基本解剖、组织学和生物力学原理，以便将其应用于手术和康复。
我们使用术语半月板、手术、康复、半月板修复和关节镜，在 1960 年至 1999 年期间，在 MEDLINE 和 CINAHL 上进行了搜索。
健康的半月板损伤通常是由膝关节从屈曲到伸展的快速切割或枢轴运动中，压缩力与横平面胫骨股骨旋转相结合而产生的。半月板手术的目的是修复功能性半月板，以防止受累膝关节发生退行性骨关节炎。康复的目的是根据患者的个体需求，基于手术类型、修复的半月板类型、是否存在并存的膝关节病理（特别是韧带松弛或关节软骨退变）、半月板撕裂的类型、患者的年龄、术前膝关节状况（包括受伤与手术之间的时间）、运动范围或力量减小以及患者的运动期望和动机，来恢复患者的功能。逐渐负重和关节受力对于增强半月板修复的功能是必要的；然而，过度的剪切力可能会造成破坏。手术后长时间的膝关节固定会导致肌肉迅速萎缩，并进一步延迟功能恢复。
结论/建议：康复方案中加速关节活动度和负重的部分代表了对创新手术固定方法的信心。在伤口愈合后，在半月板手术后的所有康复阶段（无论确切的手术类型如何），水疗环境可能是理想的，因为它具有控制负重和运动进展的优点。对于接受半月板切除术、半月板修复术或半月板重建术的患者，缺乏经过精心设计、对照、纵向的结局研究。
