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新型半月板转移技术:一例报告

Novel Meniscus Transfer Technique: A Case Report.

作者信息

Yatsonsky David, Gunn Jenna L, Dong Tony, Maxwell Aidan, Sohn David

机构信息

Orthopedic Surgery, The University of Toledo College of Medicine and Life Sciences, Toledo, USA.

College of Medicine, The University of Toledo College of Medicine and Life Sciences, Toledo, USA.

出版信息

Cureus. 2024 Jul 2;16(7):e63677. doi: 10.7759/cureus.63677. eCollection 2024 Jul.

Abstract

The meniscus is an essential component of the knee joint, acting as a shock absorber as well as assisting in the transmission of forces. Due to the meniscus importance of the knee, much of the current literature focuses on treatment techniques that can spare and repair the meniscus when it is torn. The unique vasculature of the meniscus often makes repair difficult or, in many cases, impossible. A current focus within orthopedics has been on meniscal allograft transplantation to fill this gap. The lack of a universal surgical technique for graft fixation, along with the current failure rates, demonstrates the need for further improvements. The senior author proposes a novel technique for meniscal allograft transplantation that has shown decreased blood loss and surgical time, while also reducing intra-operative trauma to the knee. This case reports a 16-year-old patient who underwent a right lateral meniscal allograft transplant following a large segmental defect tear of the lateral meniscus. The patient initially underwent arthroscopy and meniscectomy with screw fixation of the lateral femoral condyle lesion. After physical therapy, the patient experienced increased pain and swelling, with magnetic resonance imaging (MRI) demonstrating a meniscal defect unamenable to repair. The patient met indications for meniscal allograft transplantation given the failed meniscectomy, absence of cartilage loss and significant osteoarthritis, and the patient's age of less than 50 years old.

摘要

半月板是膝关节的重要组成部分,起到减震器的作用,并协助传递力量。由于半月板对膝关节的重要性,当前许多文献都聚焦于在半月板撕裂时能够保留和修复半月板的治疗技术。半月板独特的血管结构常常使修复变得困难,在许多情况下甚至无法修复。目前骨科领域的一个关注点是半月板同种异体移植,以填补这一空白。缺乏一种通用的移植物固定手术技术,以及当前的失败率,表明需要进一步改进。资深作者提出了一种新型的半月板同种异体移植技术,该技术已显示出减少了失血和手术时间,同时还减少了对膝关节的术中创伤。本病例报告了一名16岁患者,其外侧半月板出现大片段缺损撕裂后接受了右侧半月板同种异体移植。患者最初接受了关节镜检查和半月板切除术,并对股骨外侧髁病变进行了螺钉固定。物理治疗后,患者疼痛和肿胀加剧,磁共振成像(MRI)显示半月板缺损无法修复。鉴于半月板切除术失败、无软骨损伤和严重骨关节炎,且患者年龄小于50岁,该患者符合半月板同种异体移植的指征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2f2/11293484/2cab01e6e21c/cureus-0016-00000063677-i01.jpg

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