[同种异体半月板外侧移植,治疗年轻患者半月板切除术后综合征的最佳选择。病例介绍]。

Acta ortopedica mexicana Pub Date : 2024-09-01
M Zárate-de la Torre, J G Gómez-Mont-Landerreche, R A Torres-Valdés
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引用次数: 0

摘要

半月板损伤是造成膝关节内疼痛的主要原因之一,尤其是在年轻患者、运动员或对体力活动要求较高的人群中;由于其中一些损伤非常复杂,这对关节镜外科医生来说是一项挑战。目前,关节镜技术的进步使我们能够修复过去被认为无法修复的半月板损伤。虽然我们的首要任务是尽可能多地保留半月板,但在某些情况下,损伤的复杂程度会导致无法保留半月板,因此只有进行部分或全部半月板切除术才是唯一的治疗选择。在美国,每年约有 69 万例半月板部分切除术。在这种情况下,我们认为半月板移植是一种很好的治疗方法,适用于年龄较小,不适合进行关节置换术的患者。理想的患者是相对年轻的患者(骨骼成熟度在50岁之间),有半月板部分或全部切除术的病史记录,疼痛局限于受累区,保守治疗无效,没有全身性的高级别软骨缺损。我们报告了一例 35 岁男性患者的病例,他在七年前接受过右外侧半月板全切除术,目前出现了外侧半月板切除术后综合征。根据患者的临床和人口统计学特征以及影像学检查结果,异体半月板移植是缓解症状、尽可能延缓关节置换手术需求的最佳选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Lateral meniscus transplantation with allograft, a good alternative for the management of postmeniscectomy syndrome in young patients. Presentation of a case].

Meniscal injuries represent one of the main causes of intra-articular knee pain, especially in young patients, athletes or those with a high demand for physical activity; representing a challenge for the arthroscopist surgeon due to the great complexity that some of these injuries can present. Currently, the advances that have been implemented in arthroscopy allow us to repair meniscal injuries that in the past were considered irreparable. Although our priority is to preserve as much of the meniscus as possible, there are cases in which the injury reaches such complexity that this is impossible, with partial or total meniscectomy being the only therapeutic option. In the United States, approximately 690,000 partial meniscectomies are performed each year. This situation makes us consider meniscal transplantation as a great therapeutic option for patients considered young enough for joint replacement. The ideal patient is a relatively young patient (between skeletal maturity and 50 years), who has a well-documented history of partial or total meniscectomy, pain well localized to the affected compartment, with failure to conservative treatment and without high-grade chondral defects. in a generalized way. We present the case of a 35-year-old male patient with a history of total meniscectomy of the right lateral meniscus seven years ago, who currently presents with a postmeniscectomy syndrome of the lateral compartment. Due to the clinical and demographic characteristics of our patient, as well as the findings in the imaging studies, meniscal transplantation with allograft represents an excellent alternative to alleviate the symptoms and slow down as much as possible the need for joint replacement as a definitive treatment.

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