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环形半月板形成可能源于生长突增期半月板切除术后的再生反应:一例报告。

Ring-shaped meniscus formation may arise from the regenerative response to meniscectomy during growth spurts: A case report.

作者信息

Nagashima Masaki, Otani Toshiro, Kojima Kota, Aida Shinsuke, Ishii Ken

机构信息

Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3, Mita, Minato-ku, Tokyo, 108-8329, Japan; Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita city, Chiba, 286-8686, Japan.

Institute for Integrated Sports Medicine Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

出版信息

Int J Surg Case Rep. 2019;61:226-229. doi: 10.1016/j.ijscr.2019.07.056. Epub 2019 Jul 25.

Abstract

INTRODUCTION

Ring-shaped meniscus is very rare and generally considered to be a congenital malformation. Here, we report a case of newly formed ring-shaped meniscus-like tissue following arthroscopic partial meniscectomy for a complete discoid lateral meniscus.

PRESENTATION OF CASE

A 14-year-old boy underwent arthroscopic partial meniscectomy for complete discoid lateral meniscus of the left knee. The growth plates were present at the surgery. Although pain improved immediately after surgery, he reported left knee pain at the 7-month follow-up. Magnetic resonance imaging revealed a bucket-handle tear of the lateral meniscus and a second arthroscopic surgery was performed. During arthroscopy, we found that the anterior and posterior horns of the lateral meniscus were connected by meniscus-like tissue forming a ring-shaped meniscus and the newly formed interhorn meniscal bridge was resected. Histological evaluation indicated that the newly formed tissue was meniscus-like tissue that had appeared secondary to tissue repair. He visited our hospital at 16 years old, after the growth plates had closed, complaining of right knee pain. Arthroscopic partial meniscectomy was performed for complete discoid lateral meniscus of the right knee. As of two years after this surgery, no morphological changes have been observed.

DISCUSSION

Although the exact mechanisms of meniscus-like tissue formation remain unclear, the growth spurt may promote the mechanisms of tissue repair, forming ring-shaped meniscus-like tissue.

CONCLUSION

This is the first case of ring-shaped meniscus-like tissue forming after partial resection of a complete discoid lateral meniscus. Ring-shaped meniscus-like tissue can develop in growing patients.

摘要

引言

环形半月板非常罕见,通常被认为是一种先天性畸形。在此,我们报告一例在关节镜下对完全盘状外侧半月板进行部分半月板切除术后新形成的环形半月板样组织的病例。

病例介绍

一名14岁男孩因左膝完全盘状外侧半月板接受了关节镜下部分半月板切除术。手术时生长板存在。尽管术后疼痛立即改善,但他在7个月随访时报告左膝疼痛。磁共振成像显示外侧半月板桶柄样撕裂,遂进行了第二次关节镜手术。在关节镜检查期间,我们发现外侧半月板的前后角通过半月板样组织相连,形成了一个环形半月板,并切除了新形成的角间半月板桥。组织学评估表明,新形成的组织是继发于组织修复而出现的半月板样组织。他在16岁生长板闭合后来我院就诊,主诉右膝疼痛。因右膝完全盘状外侧半月板接受了关节镜下部分半月板切除术。截至该手术后两年,未观察到形态学变化。

讨论

尽管半月板样组织形成的确切机制尚不清楚,但生长突增可能促进组织修复机制,形成环形半月板样组织。

结论

这是首例完全盘状外侧半月板部分切除术后形成环形半月板样组织的病例。环形半月板样组织可在生长中的患者中出现。

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