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半月板修复:今日现状。

Meniscal Salvage: Where We Are Today.

机构信息

From the Division of Orthopaedics, Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University, Bethesda, MD (Anderson and Dickens), Geneva Foundation, Tacoma, WA (Gaston), the Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD (Gaston), and United States Naval Academy, Naval Health Clinic Annapolis, Annapolis, MD (LeClere).

出版信息

J Am Acad Orthop Surg. 2021 Jul 15;29(14):596-603. doi: 10.5435/JAAOS-D-20-00915.

Abstract

The menisci are fibrocartilaginous semilunar structures in the knee that provide load support. Injury to the meniscus alters its load sharing and biomechanical profile. Knee arthroscopy with meniscus débridement is the most common orthopaedic surgical procedure done in the United States. The current goals of meniscal surgery are to preserve native meniscal tissue and maintain structural integrity. Meniscal preservation is critical to maintain the normal mechanics and homeostasis of the knee; however, it is not always feasible because of the structure's poor blood supply and often requires removal of irreparable tissue with meniscectomy. Efforts have increasingly focused on the promotion of meniscal healing and the replacement of damaged menisci with allografts, scaffolds, meniscal implants, or substitutes. The purpose of this article was to review current and future meniscal salvage treatments such as meniscus transplant, synthetic arthroplasty, and possible bioprinted meniscus to allow patients to maintain quality of life, limit pain, and delay osteoarthritis.

摘要

半月板是膝关节内的纤维软骨半月形结构,可提供负荷支撑。半月板损伤会改变其负荷分担和生物力学特性。在美国,膝关节镜下半月板清创术是最常见的骨科手术。目前,半月板手术的目标是保留半月板组织的原有状态并维持其结构完整性。保留半月板对于维持膝关节的正常力学和内环境稳定至关重要,但由于半月板血供较差,往往需要切除不可修复的组织行半月板切除术,因此并非总是可行。目前,人们越来越关注促进半月板愈合,并使用同种异体移植物、支架、半月板植入物或替代品来替代受损的半月板。本文旨在综述目前和未来的半月板修复治疗方法,如半月板移植、人工关节置换以及可能的生物打印半月板,以帮助患者维持生活质量、减轻疼痛并延缓骨关节炎的进展。

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