Mameri Enzo S, Dasari Suhas P, Fortier Luc M, Verdejo Fernando Gómez, Gursoy Safa, Yanke Adam B, Chahla Jorge
Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St., Chicago, IL, 60612, USA.
Department of Orthopaedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil.
Curr Rev Musculoskelet Med. 2022 Oct;15(5):323-335. doi: 10.1007/s12178-022-09768-1. Epub 2022 Aug 10.
Anatomic repair of meniscal pathology is critical for restoring native joint biomechanics and kinematics for patients who suffer from meniscal tears. The purpose of this review was to summarize the pertinent anatomy, biomechanics, and kinematics of the meniscus to guide surgeons during meniscal repair procedures.
Over the past decade, there has been a growing trend to save the meniscus whenever possible. The goal of repair should be to recreate native anatomy as close as possible to recapitulate normal mechanics. Studies describing the quantitative and qualitative relationship of the meniscus roots, ligaments, and attachments are key in guiding any meniscus repair. This review summarizes these relationships, with particular emphasis on meniscal roots and other key attachments to the meniscus. The composition, embryology, vascularization, biomechanics, in vivo kinetics, and in vivo kinematics of the meniscus are also discussed in this review. Meniscal tears can cause profound functional, biomechanical, and kinematic derangements within the knee joint leading to accelerated degeneration of the articular cartilage. A strong understanding of the quantitative and qualitative relationships of the meniscus and its attachments with key arthroscopic landmarks will allow a surgeon to anatomically repair meniscal pathology in order to restore native joint biomechanics.
对于半月板撕裂患者,半月板病变的解剖修复对于恢复关节的自然生物力学和运动学至关重要。本综述的目的是总结半月板的相关解剖学、生物力学和运动学知识,以在半月板修复手术中指导外科医生。
在过去十年中,尽可能保留半月板的趋势日益明显。修复的目标应该是尽可能重建自然解剖结构,以重现正常力学。描述半月板根部、韧带和附着点的定量和定性关系的研究是指导任何半月板修复的关键。本综述总结了这些关系,特别强调了半月板根部和半月板的其他关键附着点。本综述还讨论了半月板的组成、胚胎学、血管化、生物力学、体内动力学和体内运动学。半月板撕裂可导致膝关节内严重的功能、生物力学和运动学紊乱,从而加速关节软骨退变。深入了解半月板及其附着点与关键关节镜标志的定量和定性关系,将使外科医生能够进行半月板病变的解剖修复,以恢复关节的自然生物力学。