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半月板撕裂:病理学、发病率及治疗

Meniscus Tear: Pathology, Incidence, and Management.

作者信息

Luvsannyam Enkhmaa, Jain Molly S, Leitao Ayola R, Maikawa Nicolle, Leitao Ayesha E

机构信息

Surgery, Avalon University School of Medicine, Willemstad, CUW.

Medicine, Saint James School of Medicine, Park Ridge, USA.

出版信息

Cureus. 2022 May 18;14(5):e25121. doi: 10.7759/cureus.25121. eCollection 2022 May.

DOI:10.7759/cureus.25121
PMID:35733484
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9205760/
Abstract

Meniscus tears are a common orthopedic pathology and planning a single, effective treatment is challenging. The diagnosis of meniscal tears requires detailed history-taking, physical examinations, special diagnostic tests, and most likely magnetic resonance imaging (MRI) to confirm the lesion. A good understanding of the meniscal structure including vascularity, zones, function, and affected movements with associated symptoms plays a crucial role in establishing an optimal management plan. A careful assessment of the patient's characteristics, comorbidities, post-repair rehabilitation, and patient's overall function and satisfaction are also important for ideal management. While conservative management is commonly implemented and the only option for certain patients, partial meniscectomy remains to be the most performed treatment procedure. However, partial meniscectomy is no longer the first-line therapy due to the limitation of certain patient characteristics and side effects in the long run. Instead, meniscal repair has been shown to have better long-term outcomes and is therefore recommended for all tears, especially for young patients with acute traumatic lesions. Tissue engineering has been of high interest in the current research with promising therapeutic results. This review critically evaluates and compares the management of meniscal tears with surgical versus comprehensive management using the current literature.

摘要

半月板撕裂是一种常见的骨科病症,制定单一有效的治疗方案具有挑战性。半月板撕裂的诊断需要详细的病史采集、体格检查、特殊诊断测试,很可能还需要磁共振成像(MRI)来确诊病变。深入了解半月板结构,包括血管分布、区域、功能以及伴有相关症状的受累运动,对于制定最佳治疗方案起着关键作用。仔细评估患者的特征、合并症、修复后的康复情况以及患者的整体功能和满意度,对于理想的治疗也很重要。虽然保守治疗通常被采用且是某些患者的唯一选择,但部分半月板切除术仍是最常施行的治疗手段。然而,由于某些患者特征的限制以及长期的副作用,部分半月板切除术不再是一线治疗方法。相反,半月板修复已显示出更好的长期效果,因此推荐用于所有撕裂情况,尤其是对于急性创伤性损伤的年轻患者。组织工程在当前研究中备受关注,治疗效果颇具前景。本综述利用现有文献对半月板撕裂的手术治疗与综合治疗进行了批判性评估和比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10de/9205760/498bd2795652/cureus-0014-00000025121-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10de/9205760/41cbe2b4fa00/cureus-0014-00000025121-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10de/9205760/958f4521cce7/cureus-0014-00000025121-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10de/9205760/498bd2795652/cureus-0014-00000025121-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10de/9205760/41cbe2b4fa00/cureus-0014-00000025121-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10de/9205760/958f4521cce7/cureus-0014-00000025121-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10de/9205760/498bd2795652/cureus-0014-00000025121-i03.jpg

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本文引用的文献

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The Epidemiology of Meniscus Injury.半月板损伤的流行病学。
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Cureus. 2020 Jun 13;12(6):e8590. doi: 10.7759/cureus.8590.
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Conservative vs. surgical approach for degenerative meniscal injuries: a systematic review of clinical evidence.保守与手术治疗退行性半月板损伤的比较:临床证据的系统评价。
单纯半月板修复术后康复方案:一项系统评价
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Posterior Tibial Slope Is Not Correlated With Meniscal Tears in Anterior Cruciate Ligament Reconstruction.后交叉韧带重建术中胫骨后倾角度与半月板撕裂无关。
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