Abram S G F, Beard D J, Price A J
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, United Kingdom.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, United Kingdom.
Knee. 2018 Oct;25(5):834-840. doi: 10.1016/j.knee.2018.06.001. Epub 2018 Jul 6.
The aim of this study was to deliver standardised terminology for the identification and stratification of patients with meniscal lesions of the knee.
A national group of expert surgeons was convened by the British Association for Surgery of the Knee (BASK) and a formal consensus process was undertaken following a validated methodology. A combination of nominal group techniques and an iterative Delphi process was used to develop and refine relevant definitions. Where appropriate, definitions were placed into categories to facilitate use in clinical practice and guideline development.
A degenerative meniscus develops progressively with degradation of meniscal tissue and this may be revealed by intra-meniscal high signal on magnetic resonance imaging (MRI). A meniscal tear was defined as a defect or split in the meniscocapsular complex, which can occur in a degenerative or non-degenerative meniscus. Degenerative meniscal lesions (high signal or tear) are frequent in the general population and are often incidental findings on knee MRI. Symptoms were defined and classified into three groups: (1) strongly suggestive of a treatable meniscal lesion, (2) potentially suggestive of a treatable meniscal lesion, (3) osteoarthritic. A strategy for radiological imaging (radiograph ± MRI) was agreed for the investigation of the patients with a possible meniscal tear. Meniscal lesions and tear patterns on MRI imaging were defined and classified with reference to potential treatability: (1) target, (2) possible target, (3) no target.
The agreed terminology will enable patients with meniscal lesions to be identified and stratified consistently in clinical practice, research and guideline development.
本研究的目的是提供用于识别和分层膝关节半月板损伤患者的标准化术语。
英国膝关节外科学会（BASK）召集了一组全国性的专家外科医生，并遵循经过验证的方法进行了正式的共识过程。采用名义小组技术和迭代德尔菲法相结合的方式来制定和完善相关定义。在适当的情况下，将定义进行分类以便于在临床实践和指南制定中使用。
退变半月板随着半月板组织的降解而逐渐发展，这可能通过磁共振成像（MRI）上半月板内的高信号显示出来。半月板撕裂被定义为半月板-关节囊复合体中的缺陷或裂口，可发生在退变或非退变的半月板中。退变半月板损伤（高信号或撕裂）在普通人群中很常见，并且经常是膝关节MRI检查中的偶然发现。对症状进行了定义并分为三组：（1）强烈提示可治疗的半月板损伤，（2）可能提示可治疗的半月板损伤，（3）骨关节炎。就可能存在半月板撕裂的患者的影像学检查（X线片±MRI）策略达成了一致。根据潜在的可治疗性对MRI图像上的半月板损伤和撕裂模式进行了定义和分类：（1）目标性，（2）可能的目标性，（3）非目标性。
商定的术语将使半月板损伤患者在临床实践、研究和指南制定中能够得到一致的识别和分层。
