Doral Mahmut Nedim, Bilge Onur, Huri Gazi, Turhan Egemen, Verdonk René
Hacettepe University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Department of Sports Medicine, Ankara, Turkey.
Konya N.E. University, Meram Faculty of Medicine, Department of Orthopaedics and Traumatology, Department of Sports Medicine, Konya, Turkey.
EFORT Open Rev. 2018 May 21;3(5):260-268. doi: 10.1302/2058-5241.3.170067. eCollection 2018 May.
The complex ultrastructure of the meniscus determines its vital functions for the knee, the lower extremity, and the body.The most recent concise, reliable, and valid classification system for meniscal tears is the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Classification, which takes into account the subsequent parameters: tear depth, tear pattern, tear length, tear location/rim width, radial location, location according to the popliteal hiatus, and quality of the meniscal tissue.It is the orthopaedic surgeon's responsibility to combine clinical information, radiological images, and clinical experience in an effort to individualize management of meniscal tears, taking into account factors related to the patient and lesion.Surgeons should strive not to operate in most cases, but to protect, repair or reconstruct, in order to prevent early development of osteoarthritis by restoring the native structure, function, and biomechanics of the meniscus.Currently, there are three main methods of modern surgical management of meniscus tears: arthroscopic partial meniscectomy; meniscal repair with or without augmentation techniques; and meniscal reconstruction. Meniscus surgery has come a long way from the old slogan, "If it is torn, take it out!" to the currently accepted slogan, "Save the meniscus!" which has guided evolving modern treatment methods for meniscal tears. This last slogan will probably constitute the basis for newer alternative biological treatment methods in the future. Cite this article: 2018;3 DOI: 10.1302/2058-5241.3.170067.
半月板复杂的超微结构决定了其对膝关节、下肢乃至整个身体的重要功能。最新的简洁、可靠且有效的半月板撕裂分类系统是国际关节镜、膝关节手术与运动医学学会(ISAKOS)分类,该分类考虑了以下参数:撕裂深度、撕裂形态、撕裂长度、撕裂位置/边缘宽度、径向位置、根据腘肌腱裂孔的位置以及半月板组织的质量。骨科医生有责任综合临床信息、放射影像和临床经验,考虑与患者及损伤相关的因素,以实现半月板撕裂治疗的个体化。在大多数情况下,外科医生应努力避免手术,而是进行保护、修复或重建,以通过恢复半月板的天然结构、功能和生物力学来预防骨关节炎的早期发展。目前,半月板撕裂的现代手术治疗主要有三种方法:关节镜下部分半月板切除术;有或无增强技术的半月板修复;以及半月板重建。半月板手术已经走过了漫长的历程,从旧口号“如果撕裂了,就切除!”发展到目前被广泛接受的口号“保留半月板!”,这一口号引领了半月板撕裂不断发展的现代治疗方法。最后这个口号可能会成为未来更新的替代生物治疗方法的基础。引用本文:2018;3 DOI:10.1302/2058 - 5241.3.170067 。