与半月板切除术相比,半月板修复术的比例有所提高,并应继续提高。

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Vivek Jha
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引用次数: 0

摘要

支持半月板保留的研究结果表明,在国际上,半月板修复的比例有所上升,尤其是在年轻人群中,而半月板部分切除术的比例则有所下降。半月板部分切除术的下降速度相当快,超过了半月板修复术的上升速度,这可能是由于越来越多的证据表明,对于合并关节炎的退行性撕裂患者,常规半月板部分切除术是不可取的。不过,尽管半月板修复术在增加,但仍有近95%的半月板手术是半月板部分切除术。部分半月板切除术与半月板修复术的比例似乎相当高。乐观地说,这种情况会有所改善,因为在以前被认为是 "高风险 "的情况下,包括复杂形态、中央撕裂、径向撕裂以及根部和斜面撕裂等,修复手术都取得了成功。这可能是由多种因素造成的,其中许多因素可能是外科医生无法控制的,包括多达 25% 的修复失败。然而,随着技术和器械的改进,修复的成功率正在提高。修复费用可能是一个限制因素,尤其是在医疗保险普及率低、修复费用报销不利的低收入国家。必须尽一切努力修复有可能愈合的撕裂。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Editorial Commentary: Rate of Meniscal Repair Versus Meniscectomy Has Improved and Should Continue to Improve.

As a result of research supporting meniscus preservation, evidence shows that internationally, there has been a rise in rates of meniscus repair, especially in younger population, and a decline in rates of partial meniscectomy. The decline in partial meniscectomy has been rather rapid and has outpaced the rise in meniscal repair, likely due to increasing evidence against routine partial meniscectomy in degenerative tears with coexistent arthritis. However, despite the rise in meniscus repair, close to 95% of meniscus surgeries are still partial meniscectomies. The partial meniscectomy to meniscus repair ratio seems to be rather high. Optimistically, this will improve because successful repair outcomes have been demonstrated in situations previously considered "high-risk," including complex patterns, central tears, radial tears, and root and ramp tears. This may be due to multiple factors, many of which may be beyond the control of surgeons, including the fact that as many as 25% of repairs fail to heal. Yet, with improved techniques and instrumentation, the success rate of repair is improving. The cost of repair may be a limiting factor, especially in low-income countries with poor health insurance penetration and unfavorable reimbursement of repair cost. Every effort must be made to repair a tear, which has potential to heal.

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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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