Dillon John P, Martin David K
Sportsmed SA, Stepney, Australia.
Acta Orthop Belg. 2011 Feb;77(1):18-20.
Meniscal injuries are one of the most commonly encountered problems by orthopaedic surgeons. It is well established that meniscectomy will result in increased joint surface contact forces and the predictable progression of arthritis. The management of meniscal tears has evolved and current evidence would suggest that every attempt should be made to repair meniscal tears when appropriate. The reported success rate of meniscal repair is encouraging, but relatively little is known about the outcome of repeated repair of a re-torn meniscus. This review presents an illustrative case of a recurrent lateral meniscal tear in a young female, that has required surgical repair on three occasions over a fourteen year period. Despite recurrent tears of her lateral meniscus, the patient was symptom-free in the intervening periods and at her latest operation, her articular cartilage showed minimal evidence of chondral damage. Longer-term follow-up is required to determine whether repair of a re-torn meniscus prevents the progression of degenerative changes within the knee joint that is associated with meniscectomy.
半月板损伤是骨科医生最常遇到的问题之一。众所周知，半月板切除术会导致关节面接触力增加以及关节炎的可预测进展。半月板撕裂的治疗方法已经有所发展，目前的证据表明，在适当的时候应尽一切努力修复半月板撕裂。报道的半月板修复成功率令人鼓舞，但对于再次撕裂的半月板进行重复修复的结果却知之甚少。本综述介绍了一名年轻女性复发性外侧半月板撕裂的典型病例，该患者在14年期间需要进行三次手术修复。尽管她的外侧半月板反复撕裂，但患者在两次手术期间无症状，并且在最近一次手术时，她的关节软骨仅有轻微的软骨损伤迹象。需要进行长期随访，以确定再次撕裂的半月板修复是否能防止与半月板切除术相关的膝关节内退行性改变的进展。
