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内侧半月板同种异体移植:采用解剖学前后角固定的骨栓技术

Medial Meniscus Allograft Transplantation: Bone Plug Technique With Anatomic Anterior and Posterior Horn Fixation.

作者信息

Medina Giovanna, Leite Chilan B G, Merkely Gergo, Lattermann Christian

机构信息

Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.

Harvard Medical School, Boston, Massachusetts, U.S.A.

出版信息

Arthrosc Tech. 2024 Sep 25;14(3):103260. doi: 10.1016/j.eats.2024.103260. eCollection 2025 Mar.

Abstract

Meniscus preservation is crucial for avoiding cartilage degeneration after symptomatic meniscal tears. Despite efforts, meniscal repair procedures may fail, which requires a partial or total meniscectomy. Meniscus allograft transplantation (MAT) presents a viable solution, offering symptom alleviation, enhanced knee function, and potential osteoarthritis progression delay. Although MAT can address both lateral and medial compartments, medial MAT poses greater challenges as the result of its intricate attachments and limited mobility. The medial meniscus's unique anatomy, including attachments to the intermeniscal ligament, deep medial collateral ligament, capsule, and the anterior cruciate ligament, demands meticulous transplantation techniques. Refinements in surgical techniques are ongoing, emphasizing the importance of anatomical precision, particularly in positioning the anterior and posterior horns of the medial meniscus. Here, we present a bone plug technique for medial MAT, prioritizing the accurate anatomical attachment of the anterior horns of the allograft to improve surgical outcomes.

摘要

半月板保留对于避免有症状的半月板撕裂后软骨退变至关重要。尽管做出了努力,但半月板修复手术仍可能失败,这就需要进行部分或全半月板切除术。同种异体半月板移植(MAT)是一种可行的解决方案,可缓解症状、增强膝关节功能并可能延缓骨关节炎进展。虽然MAT可用于处理外侧和内侧半月板,但内侧MAT由于其复杂的附着结构和有限的活动度而面临更大挑战。内侧半月板独特的解剖结构,包括与半月板间韧带、内侧副韧带深层、关节囊和前交叉韧带的附着,需要精细的移植技术。手术技术的改进正在进行中,强调解剖精确性的重要性,特别是在内侧半月板前后角的定位方面。在此,我们介绍一种用于内侧MAT的骨栓技术,优先考虑将同种异体移植物前角准确地进行解剖学附着,以改善手术效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6882/11977132/f9f5029ad0a6/gr1.jpg

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