Department of Orthopaedics, Clinical Sciences Lund, Lund University, Klinikgatan 22, SE-221 85 Lund, Sweden.
Nat Rev Rheumatol. 2012 May 22;8(7):412-9. doi: 10.1038/nrrheum.2012.69.
The menisci are internal structures that are of central importance for a healthy knee joint; they have a key role in the structural progression of knee osteoarthritis (OA), and the risk of the disease dramatically increases if they are damaged by injury or degenerative processes. Meniscus damage might be considered a signifying feature of incipient OA in middle-aged and elderly people. As approximately every third knee of people in these groups has a damaged meniscus, tears are common incidental findings of knee MRI. However, as most tears do not cause symptoms, careful clinical evaluation is required to determine if a damaged meniscus is likely to directly impact a patient's symptoms. Conservative management of patients with knee pain and a degenerative meniscal tear should be considered as a first-line therapy before surgical treatment is contemplated. Patients with mechanical interference of joint movements, such as painful catching or locking, might need surgical treatment with meniscal repair if possible. In a subset of patients, meniscal resection might relieve pain and other symptoms that potentially originate directly from the torn meniscus. However, the possibility of an increased risk of OA if functional meniscal tissue is removed cannot be overlooked.
半月板是膝关节内的重要结构，对膝关节健康起着关键作用；它们在膝关节骨关节炎（OA）的结构进展中起着重要作用，如果半月板因损伤或退行性过程而受损，患该病的风险会显著增加。半月板损伤可能被认为是中老年人早期 OA 的一个显著特征。由于这些人群中大约每三个人的膝关节就有一个半月板损伤，因此半月板撕裂是膝关节 MRI 的常见偶然发现。然而，由于大多数撕裂不会引起症状，因此需要仔细的临床评估来确定受损的半月板是否可能直接影响患者的症状。对于膝关节疼痛和退行性半月板撕裂的患者，在考虑手术治疗之前，应考虑保守治疗作为一线治疗。对于有膝关节运动机械干扰的患者，如有疼痛性卡顿或锁定，如有可能，可能需要半月板修复手术治疗。对于一部分患者，半月板切除术可能会缓解疼痛和其他可能直接源自撕裂半月板的症状。然而，不能忽视如果切除功能性半月板组织会增加患 OA 的风险。
