Rosenberg T D, Paulos L E, Wnorowski D C, Gurley W D
Division of Orthopedic Surgery, University of Utah, Salt Lake City.
Orthopade. 1990 Apr;19(2):82-9.
The stabilizing function of the meniscus and the negative effect of a complete or partial meniscectomy have been demonstrated in many studies. On the other hand, it has also been shown that meniscus tears in certain locations can heal very well. The prerequisite is that the torn meniscus can be revascularized from the capsule. Revascularization can be achieved by stimulating the formation of new vessels, but also by the build-up of collagen after induction of fibrochondrocytes and fibroblasts. The requirements for meniscus reconstruction are: careful preparation of the tear, exact repositioning, and precise placement of the sutures. The additional activation of regenerating processes is promoted by using a fibrin clot. In this study, 54 patients underwent meniscus repair, but the results in this group that also received a fibrin clot are not included. In the case of longitudinal-vertical tears of the meniscus inside the 3-mm zone margin, it was decided that the procedure was indicated when tears longer than 1.5 cm were concerned. The inside-out technique was used. Subjective and objective examination of 52 patients showed that the clinical results were good to very good in 92%.
许多研究已经证实了半月板的稳定功能以及完全或部分半月板切除术的负面影响。另一方面，也有研究表明，某些部位的半月板撕裂能够很好地愈合。前提是撕裂的半月板能够从关节囊重新血管化。重新血管化可以通过刺激新血管形成来实现，也可以通过诱导纤维软骨细胞和成纤维细胞后胶原蛋白的积累来实现。半月板重建的要求是：仔细处理撕裂处、精确复位以及精确放置缝线。使用纤维蛋白凝块可促进再生过程的额外激活。在本研究中，54例患者接受了半月板修复，但该组中同时接受纤维蛋白凝块治疗的结果未纳入。对于半月板3毫米边缘区内的纵向垂直撕裂，当撕裂长度超过1.5厘米时，决定采用该手术。采用了由外向内技术。对52例患者的主观和客观检查表明，92%的临床结果为良好至非常好。
