Visser Jetze, van Geenen Rutger, Wildervanck-Dekker Nynke
Radboudumc, afd. Orthopedie, Nijmegen.
Contact: Jetze Visser (
Ned Tijdschr Geneeskd. 2021 Sep 16;165:D6047.
Osteoarthritis of the knee is often accompanied by degeneration of the meniscus. Worldwide, the arthroscopic partial meniscectomy has been a standard of care for patients with knee pain in the presence a degenerative meniscal tear. However, in recent years, clinical studies have proven that a meniscectomy is not effective in the osteoarthritic knee. Physiotherapy is often as effective. The updated Dutch guidelines for meniscal tears therefore recommend an arthroscopic partial meniscectomy or fixation in case of a locked knee and for traumatic meniscal tears in younger patients. There also is an indication for a meniscectomy after failure of conservative treatment in case of a symptomatic meniscal tear in the absence of osteoarthritis.
膝关节骨关节炎常伴有半月板退变。在全球范围内，关节镜下部分半月板切除术一直是存在退行性半月板撕裂的膝关节疼痛患者的标准治疗方法。然而，近年来，临床研究证明半月板切除术对骨关节炎膝关节无效。物理治疗通常同样有效。因此，更新后的荷兰半月板撕裂指南建议，对于膝关节交锁以及年轻患者的创伤性半月板撕裂，可行关节镜下部分半月板切除术或固定术。对于无骨关节炎的有症状半月板撕裂，在保守治疗失败后也有半月板切除术的指征。
