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半月板置换的现状

The Current State of Meniscus Replacements.

作者信息

van Minnen B S, van Tienen T G

机构信息

Orthopaedic Research Lab, Radboud University Medical Centre, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.

ATRO Medical BV, Liessentstraat 9A, 5405 AH, Uden, The Netherlands.

出版信息

Curr Rev Musculoskelet Med. 2024 Aug;17(8):293-302. doi: 10.1007/s12178-024-09902-1. Epub 2024 May 14.

Abstract

PURPOSE OF REVIEW

The field of meniscus replacement is changing continuously, with new devices emerging and others disappearing from the market. With the current tendency to preserve the knee joint, meniscus implants may become more relevant than ever. The purpose of this review is to provide an overview of the current state of partial and total meniscus replacements that have been developed beyond the academic phase. The available clinical and pre-clinical data is evaluated, and omissions are identified.

RECENT FINDINGS

Recent systematic reviews have shown a lack of homogenous clinical data on the CMI and Actifit meniscal scaffolds, especially regarding long-term performance without concomitant surgical interventions. Clinical studies on the medial total meniscus prostheses NUsurface and Artimis are ongoing, with the NUsurface being several years ahead. New techniques for meniscus replacement are rapidly developing, including the Artimis lateral meniscus prosthesis and the MeniscoFix 3D-printed scaffold. All evaluated clinical studies point towards improved clinical outcomes after implantation of partial and total meniscus replacements. Long-term data on survival and performance is of low quality for CMI and Actifit and is unavailable yet for NUsurface and Artimis. It is of major importance that future research focuses on optimizing fixation methods and identifying the optimal treatment strategy for each patient group. New techniques for total and partial replacement of the medial and lateral meniscus will be followed with interest.

摘要

综述目的:半月板置换领域不断变化,新设备不断涌现,其他一些则退出市场。鉴于当前保留膝关节的趋势,半月板植入物可能比以往任何时候都更具相关性。本综述的目的是概述已走出学术阶段的部分和全半月板置换的现状。对现有的临床和临床前数据进行评估,并找出不足之处。

最新发现:最近的系统评价表明,关于CMI和Actifit半月板支架缺乏同质化的临床数据,特别是在没有伴随手术干预的情况下的长期性能方面。关于内侧全半月板假体NUsurface和Artimis的临床研究正在进行中,NUsurface的研究进展领先数年。半月板置换的新技术正在迅速发展,包括Artimis外侧半月板假体和MeniscoFix 3D打印支架。所有评估的临床研究都表明,部分和全半月板置换植入后临床结果有所改善。CMI和Actifit的生存和性能长期数据质量较低,NUsurface和Artimis的此类数据尚未可得。未来的研究重点是优化固定方法并为每个患者群体确定最佳治疗策略,这一点至关重要。内侧和外侧半月板全置换和部分置换的新技术将受到关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d9f/11219664/4ed557bd88c8/12178_2024_9902_Fig1_HTML.jpg

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