Zhang Z, Arnold J A, Williams T, McCann B
Orthopaedic Research Institute, Fayetteville, Arkansas.
Am J Sports Med. 1995 Jan-Feb;23(1):35-41. doi: 10.1177/036354659502300106.
Trephination may encourage healing of a tear in the avascular area of the meniscus, but healing may not be complete in unstable tears. We studied trephination with suture of longitudinal injuries in the avascular area of the medial meniscus in 20 goats; samples were studied at 3, 8, and 25 weeks. All 20 tears treated by trephination and suture were completely (4 samples) or partly (16 samples) healed. The average tensile strength of the healed repair was 40.4 kg/cm2 at 25 weeks. The level of DNA synthesis and tissue ingrowth decreased with time; DNA synthetic activity was also found in the chondrocytes of the menisci treated by suture alone. Only three of the menisci treated by suture alone were partly healed, and the remainder showed no gross evidence of healing. The addition of trephination to the sutured meniscus appears to promote healing of longitudinal injuries in the avascular area and is recommended rather than suturing or trephination alone. Meniscal suture alone may stabilize the tear and stimulate cell proliferation for healing, but it appears to be significantly restricted without an adequate blood supply.
钻孔术可能会促进半月板无血管区域撕裂的愈合，但对于不稳定的撕裂，愈合可能并不完全。我们对20只山羊的内侧半月板无血管区域的纵向损伤进行了钻孔术加缝合的研究；在3周、8周和25周时对样本进行研究。所有20处经钻孔术和缝合治疗的撕裂均完全（4个样本）或部分（16个样本）愈合。在25周时，愈合修复的平均拉伸强度为40.4千克/平方厘米。DNA合成和组织长入水平随时间下降；在仅接受缝合治疗的半月板软骨细胞中也发现了DNA合成活性。仅接受缝合治疗的半月板中只有三个部分愈合，其余的没有明显愈合迹象。在缝合的半月板上增加钻孔术似乎能促进无血管区域纵向损伤的愈合，因此推荐采用这种方法，而不是单独进行缝合或钻孔术。单独的半月板缝合可能会稳定撕裂并刺激细胞增殖以促进愈合，但在没有充足血液供应的情况下，愈合似乎会受到显著限制。
