Wang Sung Il
Chonbuk National University Medical School, Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea.
Acta Orthop Traumatol Turc. 2018 Jan;52(1):70-74. doi: 10.1016/j.aott.2016.09.001. Epub 2016 Oct 14.
In symptomatic discoid medial meniscus, partial meniscectomy is the principal treatment method and can yield promising short-term results. However, unlike the nondiscoid meniscus, discoid medial meniscus is frequently associated with horizontal cleavage tears, attributable to the presence of myxoid degeneration in the intrameniscal substance, in that it may potentially occur deteriorating long-term results because of re-tearing of remaining meniscus or secondary degeneration of cartilage of the medial compartment after meniscectomy. We experienced three rare cases of retear or secondary degeneration of cartilage of the medial compartment after meniscectomy for two patients with torn bilateral meniscus. Both patients were highly active young males. Meniscal allograft transplantation in complicated discoid medial meniscus was performed. At 2 years after meniscal allograft transplantation, clinical outcomes were improved with a normal range of motion. Orthopedic surgeons should recommend activity modification to prevent possible complicated injury of the discoid medial meniscus. Meniscal allograft transplantation may be an alternative option in highly active young patients undergoing complicated discoid medial meniscus to diminish pain, improve knee function, and prevent or delay degeneration.
对于有症状的盘状内侧半月板,部分半月板切除术是主要的治疗方法,且能取得不错的短期效果。然而,与非盘状半月板不同,盘状内侧半月板常伴有水平劈裂撕裂,这归因于半月板内部存在黏液样变性,因为半月板切除术后剩余半月板的再次撕裂或内侧间室软骨的继发性退变可能会导致长期效果恶化。我们遇到了两例双侧半月板撕裂患者半月板切除术后内侧间室软骨再次撕裂或继发性退变的罕见病例。两名患者均为活动量较大的年轻男性。对复杂的盘状内侧半月板进行了同种异体半月板移植。同种异体半月板移植术后2年,临床结果得到改善,活动范围正常。骨科医生应建议调整活动方式,以预防盘状内侧半月板可能出现的复杂损伤。对于患有复杂盘状内侧半月板的活动量较大的年轻患者,同种异体半月板移植可能是一种替代选择,以减轻疼痛、改善膝关节功能并预防或延缓退变。