Hanna Tammam, Smith Nathan P, Sebastianelli Wayne J
Penn State Department of Orthopedics and Rehabilitation, Penn State Sports Medicine, 1850 East Park Avenue, Suite 112, University Park, State College, PA, 16803, USA.
Penn State College of Medicine, Department of Orthopedics and Rehabilitation, Penn State Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
Curr Rev Musculoskelet Med. 2022 Jun;15(3):157-169. doi: 10.1007/s12178-022-09754-7. Epub 2022 Apr 25.
The standard of care in meniscal tear management is constantly evolving, especially for athletes and high-demand patients. Meniscus repairs, meniscus transplants, and partial meniscectomies are commonly performed, and rehabilitation methods following these operations are becoming more sophisticated. The ultimate goal of these procedures is returning patients to full activity with minimal risks. Return to play should be systematic, pathology dependent, and individualized to an athlete's needs, expectations, and level of play. This article provides a review of the current treatment modalities of meniscus tears, the rehabilitation protocols following each modality, and the return to play criteria that must be met before releasing the player to competition. In addition, it overviews articles that describe performance outcomes of patients that have undergone meniscus surgery.
Current research shows high return to play rates for athletes that undergo meniscus surgery and describes effective rehabilitation protocols to facilitate recovery. There is an increased emphasis on meniscus preservation in recent literature. In addition, meniscus allograft transplantation has demonstrated its efficacy as a salvage procedure and has become a stronger consideration in the athlete with meniscus pathology. No standardized return to play protocol can be applied uniformly to all kinds of meniscal surgeries, and two athletes with the same pathology cannot be expected to follow identical paths towards full recovery. A multidisciplinary approach to care should be provided to the patients, and in the case of patients with high levels of athleticism, the road to recovery starts even before the injury itself.
半月板撕裂治疗的护理标准不断发展,尤其是对于运动员和高需求患者。半月板修复、半月板移植和部分半月板切除术较为常见,这些手术后的康复方法也日益复杂。这些手术的最终目标是让患者以最小风险恢复全面活动。重返赛场应是系统的、取决于病理情况的,并根据运动员的需求、期望和比赛水平进行个性化安排。本文综述了半月板撕裂的当前治疗方式、每种治疗方式后的康复方案以及运动员重返赛场前必须满足的标准。此外,还概述了描述半月板手术后患者表现结果的文章。
当前研究表明,接受半月板手术的运动员重返赛场的比例较高,并描述了促进恢复的有效康复方案。近期文献越来越强调半月板的保留。此外,半月板同种异体移植已证明其作为挽救手术的有效性,对于有半月板病变的运动员来说,它已成为更值得考虑的治疗方法。没有标准化的重返赛场方案可以统一应用于所有类型的半月板手术,不能期望两名患有相同病理情况的运动员遵循完全相同的路径实现完全康复。应为患者提供多学科护理方法,对于运动能力强的患者,恢复之路甚至在受伤之前就已开始。