Goes Rodrigo Araújo, Cruz Raphael Serra, Pavão Douglas Mello, Vivacqua Thiago Alberto, Campos André Luiz Siqueira, Maia Phelippe Augusto Valente, Salim Rodrigo, Rocha de Faria José Leonardo
Sports Medicine Center, National Institute of Traumatology and Orthopedics of Brazil, Rio de Janeiro, Brazil.
Knee Surgery Center, National Institute of Traumatology and Orthopedics of Brazil, Rio de Janeiro, Brazil.
Arthrosc Tech. 2022 Jun 21;11(7):e1321-e1333. doi: 10.1016/j.eats.2022.03.017. eCollection 2022 Jul.
When there is a rupture in the meniscal roots or close to them, the menisci suddenly and considerably reduce their capacity to absorb the axial mechanical load that passes through the knee, quickly leading to the development of a process of chondral degeneration. The varus deformity of the lower limb (when the mechanical axis crosses the medial compartment of the knee) favors this type of injury owing to the overload in the medial compartment. When the patient has both varus deformity and medial meniscal posterior root injury, there is a clear indication for surgical realignment of the affected lower limb. There is still not a consensus regarding combining meniscal root repair with corrective osteotomy, although there is a tendency to perform both procedures aiming at long-term joint preservation. We present a safe alternative technique for simultaneous medial meniscal posterior root repair using a lateral tibial transosseous tunnel associated with a valgus-producing high tibial osteotomy with homologous bone grafting, allowing a full return to daily activities and sports.
当半月板根部或其附近出现撕裂时，半月板突然且显著地降低其吸收通过膝关节的轴向机械负荷的能力，迅速导致软骨退变过程的发展。下肢内翻畸形（当机械轴穿过膝关节内侧间室时）由于内侧间室的过载而有利于这种类型的损伤。当患者同时存在内翻畸形和内侧半月板后根损伤时，对于受影响下肢进行手术矫正有明确指征。尽管倾向于同时进行半月板根部修复和矫正截骨术以实现长期关节保留，但关于两者联合应用仍未达成共识。我们提出一种安全的替代技术，用于同时进行内侧半月板后根修复，采用外侧胫骨跨骨隧道联合产生外翻的高位胫骨截骨术及同种异体骨移植，可使患者完全恢复日常活动和运动。
