Maffulli Nicola, Longo Umile Giuseppe, Campi Stefano, Denaro Vincenzo
Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, England.
Open Access J Sports Med. 2010 Apr 26;1:45-54. doi: 10.2147/oajsm.s7753.
The menisci are two semilunar-shaped fibrocartilagenous structures, which are interposed between the femoral condyles and tibial plateaux. They have an important role in knee function. Long-term follow-up studies showed that virtually all meniscectomized knees develop arthritic changes with time. The meniscus has functions in load bearing, load transmission, shock absorption, joint stability, joint lubrication, and joint congruity. Because of these functions, meniscal tissue should be preserved whenever possible. A well-trained surgeon can safely rely on clinical examination for diagnosing meniscal injuries. History and clinical examination are at least as accurate as magnetic resonance imaging in the skilled orthopedic surgeon's hand. When meniscal repair is not possible, partial resection of the meniscus is indicated. Meniscal repair has evolved from open to arthroscopic techniques, which include the inside-out and outside-in suture repairs and the all-inside techniques. Meniscal transplantation is generally accepted as a management alternative option for selected symptomatic patients with previous complete or near-complete meniscectomy.
半月板是两个半月形的纤维软骨结构,位于股骨髁和胫骨平台之间。它们在膝关节功能中起着重要作用。长期随访研究表明,几乎所有接受半月板切除术的膝关节随着时间的推移都会出现关节炎变化。半月板具有承重、负荷传递、减震、关节稳定、关节润滑和关节一致性等功能。由于这些功能,应尽可能保留半月板组织。训练有素的外科医生可以安全地依靠临床检查来诊断半月板损伤。在熟练的骨科医生手中,病史和临床检查至少与磁共振成像一样准确。当半月板无法修复时,应进行半月板部分切除术。半月板修复已从开放技术发展到关节镜技术,包括由内向外和由外向内缝合修复以及全内技术。半月板移植通常被认为是先前接受过完全或近乎完全半月板切除术的选定有症状患者的一种治疗替代选择。