Fetzer Gary B, Spindler Kurt P, Amendola Annunziato, Andrish Jack T, Bergfeld John A, Dunn Warren R, Flanigan David C, Jones Morgan, Kaeding Christopher C, Marx Robert G, Matava Matthew J, McCarty Eric C, Parker Richard D, Wolcott Michelle, Vidal Armando, Wolf Brian R, Wright Rick W
TRIA Orthopaedic Center, Minneapolis, Minn, USA.
J Knee Surg. 2009 Jul;22(3):180-6. doi: 10.1055/s-0030-1247746.
This study aimed to determine the incidence of meniscal tears and describe the tear morphology and selected treatment in patients undergoing anterior cruciate ligament (ACL) reconstruction. We also will discuss the potential market for future tissue engineering aimed at preserving meniscal function. A multicenter cohort of 1014 patients undergoing ACL reconstruction between January 2002 and December 2003 was evaluated. Data on patient demographics, presence of a meniscus tear at time of ACL reconstruction, tear morphology, and meniscal treatment were collected prospectively. Meniscal tears were categorized into 3 potential tissue engineering treatment strategies: all-biologic repair, advanced repair, and scaffold replacement. Of the knees, 36% had medial meniscal tears and 44% had lateral meniscal tears. Longitudinal tears were the most common tear morphology. The most frequent treatment method was partial meniscectomy. Thirty percent of medial meniscal tears and 10% of lateral meniscal tears are eligible for all-biologic repair; 35% of medial meniscal tears and 35% of lateral meniscal tears are eligible for an advanced repair technique; and 35% of medial meniscal tears and 55% of lateral meniscal tears are eligible for scaffold replacement. Although meniscal preservation is generally accepted in the treatment of meniscal tears, most tears in this cohort were not repairable, despite contemporary methods. The results of this cohort will hopefully stimulate and focus future research and development of new tissue engineering strategies for meniscus repair.
本研究旨在确定半月板撕裂的发生率，并描述前交叉韧带（ACL）重建患者的撕裂形态及所选治疗方法。我们还将讨论未来旨在保留半月板功能的组织工程的潜在市场。对2002年1月至2003年12月期间接受ACL重建的1014例患者的多中心队列进行了评估。前瞻性收集了患者人口统计学数据、ACL重建时半月板撕裂的情况、撕裂形态及半月板治疗情况。半月板撕裂分为3种潜在的组织工程治疗策略：全生物修复、高级修复和支架置换。在这些膝关节中，36%有内侧半月板撕裂，44%有外侧半月板撕裂。纵向撕裂是最常见的撕裂形态。最常用的治疗方法是半月板部分切除术。30%的内侧半月板撕裂和10%的外侧半月板撕裂适合全生物修复；35%的内侧半月板撕裂和35%的外侧半月板撕裂适合高级修复技术；35%的内侧半月板撕裂和55%的外侧半月板撕裂适合支架置换。尽管在半月板撕裂的治疗中半月板保留一般被认可，但尽管有现代方法，该队列中的大多数撕裂仍无法修复。该队列的结果有望激发并聚焦于未来半月板修复新组织工程策略的研究与开发。
