半月板修复与集中:保留半月板功能

Nobutake Ozeki , Tomomasa Nakamura , Yusuke Nakagawa , Ichiro Sekiya , Hideyuki Koga
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引用次数: 0

摘要

目的半月板损伤和半月板挤压引起半月板功能障碍,进而导致膝关节骨性关节炎的发生和发展。因此,半月板保留手术在预防长期软骨退化方面发挥着重要作用。本文的目的是回顾半月板保留手术的最新信息,如半月板修复和集中。方法回顾近年来有关半月板保留手术的文献。我们汇编了一些特殊半月板病变的切片,包括斜坡病变、盘状外侧半月板、退行性半月板撕裂、后根撕裂和半月板挤压。结果半月板修复术后再次手术率高于关节镜下半月板部分切除术;然而,长期随访研究表明,与半月板部分切除术相比,半月板修复术的临床效果更好,退行性变化也不那么严重。因此,当需要手术干预时,半月板修复应被视为任何半月板损伤的第一选择。半月板后根撕裂严重影响半月板环功能,加速软骨退化和伴随的半月板挤压。因此,应尽早考虑手术修复。开发了一种集中程序,以减少弯月面挤压并改善弯月面环箍功能。长期随访也应被认为是预防骨关节炎的关键。结论在中短期随访中,半月板保留术可获得满意的临床效果。对半月板病理学的进一步了解和手术技术的不断发展将提高半月板保存手术的效果。这些手术的长期疗效也应得到证实,以验证这种治疗半月板功能障碍的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Meniscus repair and centralization: Preserving meniscus function

Purpose

Meniscus injury and meniscus extrusion cause meniscus dysfunction, which then leads to the initiation and progression of knee osteoarthritis. Meniscus preservation surgery therefore plays an important role in preventing long-term cartilage degeneration. The purpose of this paper was to review the current information about meniscus preservation surgeries, such as meniscal repair and centralization.

Methods

We reviewed recent articles related to meniscus preservation surgery. We compiled sections for some special meniscus pathologies, including ramp lesion, discoid lateral meniscus, degenerative meniscus tear, posterior root tear, and meniscus extrusion.

Results

Reoperation rates are higher after meniscal repair compared with arthroscopic partial meniscectomy; however, long-term follow-up studies have demonstrated better clinical outcomes and less severe degenerative changes for meniscal repair than for partial meniscectomy. Therefore, meniscal repair should be considered the first option for any meniscus injury when surgical intervention is necessary. Posterior root tears of the meniscus substantially affect meniscal hoop function and accelerate cartilage degeneration and accompanying meniscus extrusion. Therefore, surgical repair should be considered as early as possible. A centralization procedure has been developed to reduce meniscus extrusion and improve meniscus hoop function. Long-term follow-up should also be considered essential for the prevention of osteoarthritis.

Conclusions

Meniscus preservation surgery provides satisfactory clinical outcomes at short- and mid-term follow-up. Further understanding of meniscus pathology and continued development of surgical techniques will improve the outcomes of meniscus preservation surgery. The long-term efficacy of these procedures should also be confirmed to validate this treatment strategy for meniscus dysfunction.

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