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半月板撕裂:当前的认识、诊断与治疗

Meniscal Tears: Current Understanding, Diagnosis, and Management.

作者信息

Bhan Kavyansh

机构信息

Department of Trauma and Orthopaedics, Whipps Cross University Hospital, London, GBR.

出版信息

Cureus. 2020 Jun 13;12(6):e8590. doi: 10.7759/cureus.8590.

Abstract

From once being labelled as a functionless remain of leg muscle, extensive scientific investigations in recent decades have described the meniscus as one of the most crucial structures of the knee. The incidence of meniscal injuries is on the rise and can be attributed to the increased participation of youth in sporting activities. MRI continues to be the imaging modality of choice, and surgical management is the mainstay of treatment for meniscal tears. Arthroscopic partial meniscectomy (APM) is currently the most performed orthopedic procedure around the globe. However, recent studies have conclusively shown that outcomes after an APM are no better than the outcomes after a sham/placebo surgery. Meniscal repair is now being touted as a viable and effective alternative. Meniscal repair aims to achieve meniscal healing while completely avoiding the adverse effects of partial meniscectomy. Meniscal repairs have grown in popularity over the past three decades and have proved to be a much more efficient alternative to partial meniscectomy. It is now increasingly recommended to attempt meniscal repair in all repairable tears, especially in young and physically active patients. Partial Meniscal implants have also shown excellent outcomes in long-term studies, but its efficacy in acute settings still requires further research. Research performed on various techniques of meniscal regeneration looks promising, and regenerative medicine appears to be the way forward. This review aims to critically discuss the current understanding of the meniscus, its role in biomechanics of the knee joint, and the current methods used to diagnose and manage meniscal tears.

摘要

半月板曾一度被视为腿部肌肉中无功能的残余部分,但近几十年来广泛的科学研究已将其描述为膝关节最关键的结构之一。半月板损伤的发生率呈上升趋势,这可归因于年轻人参与体育活动的增加。磁共振成像(MRI)仍然是首选的成像方式,手术治疗是半月板撕裂的主要治疗方法。关节镜下部分半月板切除术(APM)是目前全球范围内实施最多的骨科手术。然而,最近的研究已确凿表明,APM后的效果并不比假手术/安慰剂手术后的效果更好。半月板修复现在被吹捧为一种可行且有效的替代方法。半月板修复旨在实现半月板愈合,同时完全避免部分半月板切除术的不良影响。在过去三十年中,半月板修复越来越受欢迎,并且已被证明是部分半月板切除术更有效的替代方法。现在越来越建议对所有可修复的撕裂尝试进行半月板修复,尤其是在年轻且身体活跃的患者中。部分半月板植入物在长期研究中也显示出优异的效果,但其在急性情况下的疗效仍需进一步研究。对各种半月板再生技术的研究看起来很有前景,再生医学似乎是未来的发展方向。本综述旨在批判性地讨论目前对半月板的认识、其在膝关节生物力学中的作用以及用于诊断和处理半月板撕裂的当前方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b29d/7359983/7400db1460e6/cureus-0012-00000008590-i01.jpg

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