Zhang Shurong, Chen Gang, Li Ruixin, Yang Chunxi, Zheng Jiapeng, Wang Cheng, Lu Jun, Zhang Zhengzheng, Shang Xiliang, Zhang Hui, Wang Weiming, Li Weiping, Huang Jingmin, Zhang Yadong, Wang Jianquan, Wang You, Zheng Xiaofei, Chen Shiyi, Li Jian, Hua Yinghui
Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Orthopaedic Research Institution, Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, China.
Orthop J Sports Med. 2022 Dec 9;10(12):23259671221138082. doi: 10.1177/23259671221138082. eCollection 2022 Dec.
The lateral meniscus is a unique structure of the knee joint, and its anatomy, function, pathological process, and treatment are distinct from those of the medial meniscus. To date, no consensus on the management of lateral meniscal lesions has been published, and clinical decision-making is challenging. To facilitate this, consensus and practice guidelines for lateral meniscal lesions were developed and endorsed by the Chinese Society of Sports Medicine.
Consensus statement.
This project followed the Delphi approach to the consensus process, involving steering, rating, and peer review groups. A total of 61 experts in the fields of sports medicine and arthroscopic surgery were invited to participate in the compilation of a consensus statement on lateral meniscal lesions. (The discoid lateral meniscus was addressed by separate consensus.) To begin, the steering group drafted a set of questions and replies regarding lateral meniscal lesions. An online panel discussion was then held to provide initial agreement and comments on the statements, followed by a round of anonymous voting. Results and feedback were sent to the steering group for a second draft. A second round of voting was then held, and each statement was discussed during a combined meeting of the steering and rating groups. Finally, a consensus draft was evaluated by a review group.
Fifty-three questions and answers addressing lateral meniscal lesions were drafted, and 20 statements were excluded because of redundant information during the first round of voting. Ultimately, 33 statements were completed, 9 of which were unanimous.
This expert consensus process focused on the anatomy, function, pathological processes, and treatment of lateral meniscal lesions. Accepted recommendations in these areas can assist doctors and therapists in standardizing the management of related pathology. The consensus statement indicates that certain types of lateral meniscal tears that were previously considered irreparable can be repaired. Preservation of the lateral meniscus should be the first-line treatment whenever possible, because the long-term clinical and radiological outcomes are worse after partial meniscectomy.
外侧半月板是膝关节的独特结构，其解剖、功能、病理过程及治疗均与内侧半月板不同。迄今为止，关于外侧半月板损伤的治疗尚未达成共识，临床决策具有挑战性。为便于开展工作，中国运动医学学会制定并认可了外侧半月板损伤的共识及实践指南。
共识声明。
本项目采用德尔菲法进行共识制定过程，涉及指导组、评级组和同行评审组。共邀请了61位运动医学和关节镜外科领域的专家参与编写外侧半月板损伤的共识声明。（盘状外侧半月板由单独的共识进行阐述。）首先，指导组起草了一组关于外侧半月板损伤的问题及答案。随后进行了在线小组讨论，以就这些声明达成初步共识并提供意见，接着进行了一轮匿名投票。结果和反馈被发送给指导组以形成第二稿。然后进行了第二轮投票，并在指导组和评级组合并会议期间对每条声明进行了讨论。最后，由评审组对共识草案进行评估。
起草了53条关于外侧半月板损伤的问答，在第一轮投票期间，由于信息冗余，排除了20条声明。最终完成了33条声明，其中9条获得一致通过。
这一专家共识过程聚焦于外侧半月板损伤的解剖、功能、病理过程及治疗。这些领域中被认可的建议可协助医生和治疗师规范相关病理情况的管理。共识声明表明，某些先前被认为无法修复的外侧半月板撕裂现在可以修复。只要有可能，保留外侧半月板应作为一线治疗方法，因为半月板部分切除术后的长期临床和影像学结果更差。
