van Trommel M F, Simonian P T, Potter H G, Wickiewicz T L
The Sports Medicine Service, The Hospital for Special Surgery, New York, New York, USA.
Arthroscopy. 1998 May-Jun;14(4):360-5. doi: 10.1016/s0749-8063(98)70002-7.
Peripheral lateral meniscal tears are amenable to arthroscopic meniscal repair. However, the posterolateral aspect of the lateral meniscus adjacent to the popliteus tendon is devoid of penetrating peripheral vessels and therefore difficult to heal. A complete radial split at this site is usually treated with total meniscectomy. We report five cases of a tear of the posterolateral aspect of the lateral meniscus anterior to the popliteus fossa. All patients had a radial split that extended to the popliteus tendon. In all cases, the repair was enhanced with a fibrin clot. Second-look arthroscopy showed that healing of the periphery occurred in all of the cases. All patients returned to their initial level of sports activity. Three of five patients were available for follow-up at an average of 71 months, and magnetic resonance imaging was performed at that time to assess the previously repaired meniscus. All menisci were fully healed and showed no further signs of degeneration. The ability of an exogenous fibrin clot to stimulate and support a reparative response in the avascular portion of the meniscus may represent a potential method of repair. Awareness of the relatively low healing potential of this zone and enhancement of healing opportunities should improve outcome.
外侧半月板外周撕裂适合进行关节镜下半月板修复。然而，外侧半月板与腘肌腱相邻的后外侧部分缺乏穿透性外周血管，因此难以愈合。该部位的完全放射状撕裂通常采用半月板全切除术治疗。我们报告了5例位于腘肌窝前方的外侧半月板后外侧撕裂病例。所有患者均有延伸至腘肌腱的放射状撕裂。在所有病例中，均使用纤维蛋白凝块加强修复。二次关节镜检查显示所有病例的外周均愈合。所有患者均恢复到最初的运动水平。5例患者中有3例接受了平均71个月的随访，当时进行了磁共振成像以评估先前修复的半月板。所有半月板均完全愈合，未显示进一步退变迹象。外源性纤维蛋白凝块刺激和支持半月板无血管部分修复反应的能力可能代表一种潜在的修复方法。认识到该区域相对较低的愈合潜力并增加愈合机会应能改善治疗效果。
