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年轻运动员半月板损伤的治疗

Treatment of meniscal injuries in young athletes.

作者信息

Giuliani Jeffrey R, Burns Travis C, Svoboda Steven J, Cameron Kenneth L, Owens Brett D

机构信息

John A. Feagin, Jr. Sports Medicine Fellowship, Keller Army Hospital, U.S. Military Academy, West Point, NY 10996, USA.

出版信息

J Knee Surg. 2011 Jun;24(2):93-100. doi: 10.1055/s-0031-1280877.

Abstract

The young, active patient with a meniscal tear poses a significant challenge for the surgeon. Multiple factors influence the treatment of meniscal pathology and the ultimate goal of meniscal surgery should be to remove only torn and nonfunctional tissue by limited meniscectomy or to repair amenable tears. The chondroprotective significance of the meniscus has influenced the current treatment of meniscal injuries in young athletes with the emphasis on repairing meniscus tears to include complex tears and tears in the avascular zone. Partial meniscectomy and meniscal repair techniques have provided good long-term clinical success and return to activity. The decision to debride versus repair a meniscus depends on tear pattern, location, and the patient's willingness to comply with postoperative restrictions. In patients with symptomatic meniscus deficiency, meniscal allograft transplant is an option that may provide pain relief but may not allow return to sports. The purpose of this article is to provide a succinct review of the diagnostic and management principles for the young, active patient with a meniscal tear.

摘要

对于年轻、活跃且患有半月板撕裂的患者,外科医生面临着重大挑战。多种因素影响半月板病变的治疗,半月板手术的最终目标应是通过有限的半月板切除术仅切除撕裂且无功能的组织,或修复可修复的撕裂。半月板的软骨保护意义影响了当前对年轻运动员半月板损伤的治疗,重点是修复半月板撕裂,包括复杂撕裂和无血管区的撕裂。部分半月板切除术和半月板修复技术已取得良好的长期临床效果并能使患者恢复活动。决定对半月板进行清创还是修复取决于撕裂模式、位置以及患者遵守术后限制的意愿。对于有症状的半月板缺损患者,半月板同种异体移植是一种选择,它可能缓解疼痛,但可能无法让患者恢复运动。本文的目的是对年轻、活跃且患有半月板撕裂的患者的诊断和管理原则进行简要综述。

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