Rothermich Marcus A, Cohen Jared A, Wright Rick
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri.
School of Medicine, St. Louis University, St. Louis, Missouri.
J Knee Surg. 2016 Apr;29(3):228-34. doi: 10.1055/s-0035-1549020. Epub 2015 Apr 30.
Meniscal tears can be incidentally encountered at the time of anterior cruciate ligament (ACL) reconstruction. In these cases, the surgeon has several treatment options that include benign neglect, debridement, trephination, and repair. The authors performed a systematic review of the literature studying the various treatment options for meniscal tears discovered at the time of ACL reconstruction. This systematic review included eight articles that had relevant data regarding benign neglect compared with debridement, trephination, or repair of incidentally encountered meniscal tears. Combined data from these studies resulted in a total of 646 meniscal tears treated with benign neglect with follow-up information available. Importantly, there were differences in reoperation rates between medial and lateral meniscal tears left in situ. However, stable medial and lateral meniscal tears treated with benign neglect did not have different subjective or objective outcomes than those treated with surgical intervention. This systematic review concludes that when stable meniscal tears are encountered at the time of arthroscopic ACL reconstruction, benign neglect can be used for a successful outcome.
半月板撕裂可能在进行前交叉韧带（ACL）重建时偶然被发现。在这些情况下，外科医生有多种治疗选择，包括保守观察、清创、钻孔和修复。作者对研究ACL重建时发现的半月板撕裂的各种治疗选择的文献进行了系统综述。该系统综述纳入了八篇文章，这些文章具有关于保守观察与清创、钻孔或修复偶然发现的半月板撕裂的相关数据。这些研究的综合数据得出，共有646例半月板撕裂采用保守观察治疗且有随访信息。重要的是，原位保留的内侧和外侧半月板撕裂的再次手术率存在差异。然而，采用保守观察治疗的稳定的内侧和外侧半月板撕裂与接受手术干预的半月板撕裂相比，主观或客观结果并无不同。该系统综述得出结论，当在关节镜下ACL重建时遇到稳定的半月板撕裂时，保守观察可取得成功的治疗效果。
