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半月板:基础科学与治疗方法

The Meniscus: Basic Science and Therapeutic Approaches.

作者信息

Kuczyński Nikodem, Boś Julia, Białoskórska Kinga, Aleksandrowicz Zuzanna, Turoń Bartosz, Zabrzyńska Maria, Bonowicz Klaudia, Gagat Maciej

机构信息

Department of Morphological and Physiological Sciences, Faculty of Medicine, Collegium Medicum, Mazovian Academy in Płock, 09-402 Płock, Poland.

Department of Trauma and Orthopedics, Regional Specialist Hospital in Grudziądz, 86-300 Grudziądz, Poland.

出版信息

J Clin Med. 2025 Mar 16;14(6):2020. doi: 10.3390/jcm14062020.

Abstract

The proper function and longevity of the knee joint are ensured by the knee menisci. Their susceptibility to damage and injury is one of the main risk factors for rapid cartilage loss and the development of osteoarthritis. The vascularization pattern and nutritional status of a torn meniscus determine its potential for healing and the success of meniscus surgery. Blood supply is a crucial factor in assessing healing potential. Knee cartilage volume loss and its modification often result from meniscal damage or excision, leading to osteoarthritis. Modern methods for preserving meniscal tissue are currently the treatment of choice. Magnetic resonance imaging (MRI) is the gold standard for assessing meniscus lesions. It provides a comprehensive evaluation of tear stability and progression risk. Additionally, it offers high sensitivity and specificity. Arthrography combined with computed tomography (CT) can be used for patients who are unable to undergo MRI. Other methods, such as X-ray and ultrasound, are not useful for the typical diagnosis of meniscal lesions. Minimally invasive surgery has become the gold standard for both treatment and diagnosis. Modern techniques, such as all-inside compression sutures and other suturing techniques, are also considered. In contrast, in the past, open total meniscectomy was routinely performed as the gold standard, based on the mistaken belief that the menisci were functionless. Currently, new treatment methods for meniscal lesions are being explored, including mesenchymal stem cells, synthetic implants, and platelet-rich plasma (PRP). The crucial role of the menisci in knee biomechanics drives the development of modern solutions focused on preserving meniscal tissue.

摘要

膝关节半月板确保了膝关节的正常功能和寿命。它们易受损伤是软骨快速流失和骨关节炎发展的主要风险因素之一。撕裂半月板的血管化模式和营养状况决定了其愈合潜力和半月板手术的成功率。血液供应是评估愈合潜力的关键因素。膝关节软骨体积减少及其改变通常是由半月板损伤或切除引起的,进而导致骨关节炎。目前,保留半月板组织的现代方法是首选治疗方式。磁共振成像(MRI)是评估半月板损伤的金标准。它能全面评估撕裂的稳定性和进展风险。此外,它具有高敏感性和特异性。关节造影结合计算机断层扫描(CT)可用于无法进行MRI检查的患者。其他方法,如X射线和超声,对半月板损伤的典型诊断并无用处。微创手术已成为治疗和诊断的金标准。还会考虑现代技术,如全内加压缝合和其他缝合技术。相比之下,过去基于半月板无功能的错误观念,常规进行开放性全半月板切除术作为金标准。目前,正在探索半月板损伤的新治疗方法,包括间充质干细胞、合成植入物和富血小板血浆(PRP)。半月板在膝关节生物力学中的关键作用推动了专注于保留半月板组织的现代解决方案的发展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9acd/11942698/1f8afd636a37/jcm-14-02020-g001.jpg

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