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部分半月板切除术的生物力学和临床结果。

Biomechanics and Clinical Outcomes of Partial Meniscectomy.

机构信息

From the Division Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, University of California San Francisco Medical Center, San Francisco, CA (Dr. Feeley) and the Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC (Dr. Lau).

出版信息

J Am Acad Orthop Surg. 2018 Dec 15;26(24):853-863. doi: 10.5435/JAAOS-D-17-00256.

Abstract

Partial meniscectomy for meniscus tears is one of the most common procedures performed by orthopaedic surgeons. Much research has been done to evaluate the biomechanical consequences and clinical outcomes from meniscus débridement. Biomechanically, as the portion of the meniscus that is removed increases, greater contact pressures are experienced by the cartilage, which leads to altered knee mechanics. The use of partial meniscectomy to manage degenerative meniscus tears in knees with mild preexisting arthritis and mechanical symptoms may be beneficial; however, its routine use in the degenerative knee over physical therapy alone is not supported. In younger populations, partial meniscectomy may provide equal long-term symptom relief, earlier return to play, and lower revision surgery rate compared with meniscal repair. Partial meniscectomy may result in earlier development of osteoarthritis. Treatment should be patient specific in a shared-decision making process with the patient after discussion about known outcomes.

摘要

半月板部分切除术是矫形外科医生最常进行的手术之一。已经进行了大量研究来评估半月板清创术的生物力学后果和临床结果。从生物力学的角度来看,随着切除的半月板部分增加,软骨承受的接触压力更大,从而导致膝关节力学改变。在膝关节存在轻度先前关节炎和机械症状的情况下,使用半月板部分切除术来治疗退行性半月板撕裂可能是有益的;然而,与单独进行物理治疗相比,其在退行性膝关节中的常规使用并没有得到支持。在年轻人群中,与半月板修复相比,半月板部分切除术可能提供同等的长期症状缓解、更早地恢复运动和更低的翻修手术率。半月板部分切除术可能导致更早出现骨关节炎。在与患者讨论已知结果后,应根据患者的具体情况,在共同决策过程中进行治疗。

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