Grassi Alberto, Lucidi Gian Andrea, Agostinone Piero, di Paolo Stefano, Dal Fabbro Giacomo, Zaffagnini Stefano
II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Ann Jt. 2022 Apr 15;7:18. doi: 10.21037/aoj-21-2. eCollection 2022.
The menisci increase the stability of the tibio-femoral joint, distribute axial load, absorb shock, and provide nutrition and lubrification to the knee articular cartilage. Therefore, is it clear the importance of the meniscus on the overall knee function and the need to preserve it during arthroscopic surgery. However, according to many registry databases, meniscectomy is still the most performed meniscus surgery. In a percentage of patients, knee pain and swelling, as well as bone edema on the tibial plateau, could follow meniscus resection; this constellation of symptoms is known as "post-meniscectomy syndrome". If this syndrome is not promptly managed, a rapid worsening of the symptoms and develop of knee osteoarthritis could be expected. While dealing with such condition, the clinician must perform first an accurate clinical examination and a full radiological evaluation. If the patient is candidate for surgery, the replacement of the resected tissue should be performed: a meniscus allograft should be implanted in case of previous total meniscectomy or a meniscus scaffold if the patients has an history of a previous partial resection. The present article represents a comprehensive review of the literature and aims to discuss basic science, preoperative planning and evaluation, indication, surgical technique, and outcomes of the lateral collagen meniscus implant (CMI), a biologic scaffold aimed at replacing partial meniscal defects.
半月板可增强胫股关节的稳定性，分散轴向负荷，吸收冲击，并为膝关节软骨提供营养和润滑。因此，半月板对膝关节整体功能的重要性以及在关节镜手术中保留半月板的必要性是显而易见的。然而，根据许多登记数据库，半月板切除术仍然是最常进行的半月板手术。在一定比例的患者中，半月板切除术后可能会出现膝关节疼痛、肿胀以及胫骨平台骨水肿；这一系列症状被称为“半月板切除术后综合征”。如果这种综合征得不到及时处理，预计症状会迅速恶化并发展为膝关节骨关节炎。在处理这种情况时，临床医生必须首先进行准确的临床检查和全面的影像学评估。如果患者适合手术，应进行切除组织的置换：如果之前是全半月板切除术，则应植入半月板同种异体移植物；如果患者有过部分切除术病史，则应植入半月板支架。本文对文献进行了全面综述，旨在讨论外侧胶原半月板植入物（CMI）的基础科学、术前规划与评估、适应症、手术技术及结果，CMI是一种旨在替代部分半月板缺损的生物支架。
