Langhans Mark T, Lamba Abhinav, Saris Daniel B F, Smith Patrick, Krych Aaron J
Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
Columbia Orthopaedic Group, Columbia, MO, USA.
Curr Rev Musculoskelet Med. 2023 Jul;16(7):316-327. doi: 10.1007/s12178-023-09840-4. Epub 2023 May 16.
The concept of meniscal extrusion has recently been recognized as a hallmark of meniscus dysfunction. This review examines contemporary literature regarding the pathophysiology, classification, diagnosis, treatment, and future directions for investigation regarding meniscus extrusion.
Meniscus extrusion, defined as >3 mm of radial displacement of the meniscus, leads to altered knee biomechanics and accelerated knee joint degeneration. Meniscus extrusion has been associated with degenerative joint disease, posterior root and radial meniscal tears, and acute trauma. Meniscus centralization and meniscotibial ligament repair have been proposed as techniques to address meniscal extrusion with promising biomechanical, animal model, and early clinical reports. Further studies on the epidemiology of meniscus extrusion and associated long-term nonoperative outcomes will help to elucidate its role in meniscus dysfunction and resultant arthritic development. Understanding and appreciation for the anatomic attachments of the meniscus will help to inform future repair techniques. Long-term reporting on the clinical outcomes of meniscus centralization techniques will yield insights into the clinical significance of meniscus extrusion correction.
半月板挤出的概念最近被认为是半月板功能障碍的一个标志。本综述探讨了有关半月板挤出的病理生理学、分类、诊断、治疗及未来研究方向的当代文献。
半月板挤出定义为半月板径向位移>3mm,会导致膝关节生物力学改变和膝关节退变加速。半月板挤出与退行性关节病、后根和放射状半月板撕裂以及急性创伤有关。半月板复位和半月板胫骨韧带修复已被提议作为解决半月板挤出的技术,有前景的生物力学、动物模型及早期临床报告支持这些技术。关于半月板挤出的流行病学及相关长期非手术治疗结果的进一步研究,将有助于阐明其在半月板功能障碍及由此导致的关节炎发展中的作用。了解半月板的解剖附着有助于为未来的修复技术提供依据。关于半月板复位技术临床结果的长期报告,将深入了解半月板挤出矫正的临床意义。