后内侧半月板根撕裂:临床意义、手术处理和术后康复考虑。

IF 1.6 Q3 SPORT SCIENCES
Jill K Monson, Robert F LaPrade
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引用次数: 0

摘要

后内侧半月板根撕裂(PMMR)在老年患者中很常见,据报道随着时间的推移会导致关节快速退变。近年来,通过临床检查和诊断成像对这些撕裂类型的识别和适当的诊断有了显著的提高,解决这些问题的外科技术也有了显著的提高。在科学文献中,针对PMMR修复的标准化术后康复方案尚未建立或得到很好的理解。因此,临床医生对术后护理的指导很少。在诊断出半月板根撕裂后,适当的手术治疗,以及对半月板根的解剖和功能的欣赏,是恢复的关键的第一步。术后康复方案应考虑到根撕裂所特有的生物力学因素,因为它们会破坏整个半月板的稳定并损害其原有功能。康复专家可以应用有关关节运动、肌肉强化活动、步态、下蹲和渐进式负荷活动对正在愈合的半月板的影响的已知科学来指导术后恢复。这些知识与现有的良好术后康复的基本原则相辅相成,可以优化PMMR修复后患者的恢复。本临床评论的目的是探讨与PMMR损伤流行病学相关的临床问题,2)PMMR撕裂的诊断和手术处理,以及3)安全有效的术后康复的关键注意事项。证据等级:5。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Posterior Medial Meniscus Root Tears: Clinical Implications, Surgical Management, and Post-operative Rehabilitation Considerations.

Tears of the posterior medial meniscus root (PMMR) are common in older patients and reportedly contribute to rapid joint degeneration over time. Recognition of these tear types and the appropriate diagnosis through clinical exam and diagnostic imaging have improved significantly in recent years, as have surgical techniques to address them. Standardized post-operative rehabilitation protocols specific to PMMR repair have not been established or well understood in the scientific literature. Thus, clinicians have little guidance for managing post-operative care. Upon diagnosis of a root tear, appropriate surgical treatment, with appreciation for native anatomy and function of the meniscus root, is a critical first step for recovery. Post-operative rehabilitation protocols should account for biomechanical considerations unique to root tears, because they can destabilize the entire meniscus and compromise its native function. Rehabilitation specialists can apply known science regarding the influence of joint motion, muscle strengthening activities, gait, squatting, and progressive loading activities on the healing meniscus to guide post-operative recovery. This knowledge, complemented with existing foundational principles for sound post-operative rehabilitation, can optimize recovery for patients following PMMR repair. The purpose of this clinical commentary is to explore clinical questions related to 1) PMMR injury epidemiology, 2) diagnosis and surgical management of PMMR tears, and 3) critical considerations for safe and effective post-operative rehabilitation. Level of Evidence: 5.

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来源期刊
CiteScore
2.50
自引率
5.90%
发文量
124
审稿时长
16 weeks
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