Department of Orthopedic Surgery, Washington University, St. Louis, MO, USA.
J Am Acad Orthop Surg. 2012 May;20(5):265-72. doi: 10.5435/JAAOS-20-05-265.
As a result of biologic issues and technical limitations, repair of the meniscus is indicated for unstable, peripheral vertical tears; most other types of meniscal tears that are degenerative, significantly traumatized, and/or located in an avascular area of the meniscus are managed with partial meniscectomy. Options to restore the meniscus range from allograft transplantation to the use of synthetic technologies. Recent studies demonstrate good long-term outcomes from meniscal allograft transplantation, although the indications and techniques continue to evolve and the long-term chondroprotective potential has yet to be determined. Several synthetic implants, none of which has US Food and Drug Administration approval, have shown some promise for replacing part or all of the meniscus, including the collagen meniscal implant, hydrogels, and polymer scaffolds.
由于生物学问题和技术限制，半月板修复适用于不稳定的、外周垂直撕裂；大多数其他类型的半月板撕裂，如退行性、明显创伤性和/或位于半月板无血管区的半月板撕裂，采用半月板部分切除术治疗。修复半月板的选择范围从同种异体移植到合成技术的应用。最近的研究表明，半月板同种异体移植有良好的长期效果，尽管适应证和技术仍在不断发展，长期的软骨保护潜力尚未确定。几种合成植入物，均未获得美国食品和药物管理局的批准，显示出一定的潜力，可以替代部分或全部半月板，包括胶原半月板植入物、水凝胶和聚合物支架。
