Department of Orthopedics, Knee Surgery Division of the Santa Casa School of Medicine and Hospitals of São Paulo, São Paulo, Brazil,
Curr Rev Musculoskelet Med. 2014 Sep;7(3):247-55. doi: 10.1007/s12178-014-9227-x.
The preservation of meniscal tissue is paramount for long-term joint function, especially in younger patients who are athletically active. Many studies have reported encouraging results following the repair of meniscus tears, including both simple longitudinal tears located in the periphery and complex multiplanar tears that extend into the central third avascular region. However, most types of meniscal lesions are managed with a partial meniscectomy. Options to restore the meniscus range from an allograft transplantation to the use of synthetic and biological technologies. Recent studies have demonstrated good long-term outcomes with meniscal allograft transplantation, although the indications and techniques continue to evolve, and the long-term chondroprotective potential of this approach has yet to be determined. Several synthetic implants, most of which are approved in the European market, have shown some promise for replacing part of or the entire meniscus, including collagen meniscal implants, hydrogels, and polymer scaffolds. Currently, there is no ideal implant generated by means of tissue engineering. However, meniscus tissue engineering is a fast developing field that promises to develop an implant that mimics the histologic and biomechanical properties of a native meniscus.
半月板组织的保存对于长期的关节功能至关重要,特别是对于活跃于运动的年轻患者。许多研究报告了半月板撕裂修复后的令人鼓舞的结果,包括位于边缘的简单纵向撕裂和延伸至中央无血管区的第三区的复杂多平面撕裂。然而,大多数类型的半月板损伤都是通过部分半月板切除术来治疗的。修复半月板的选择范围从同种异体移植到使用合成和生物技术。最近的研究表明,半月板同种异体移植具有良好的长期效果,尽管适应证和技术仍在不断发展,并且这种方法的长期软骨保护潜力尚未确定。几种合成植入物,其中大多数在欧洲市场获得批准,显示出了替代部分或整个半月板的一些希望,包括胶原半月板植入物、水凝胶和聚合物支架。目前,还没有通过组织工程产生的理想植入物。然而,半月板组织工程是一个快速发展的领域,有望开发出一种模仿天然半月板组织学和生物力学特性的植入物。