Abstract:
The menisci increase the contact area of load bearing in the knee and thus disperse the mechanical stress via their circumferential tensile fibers. Traumatic meniscus injuries cause mechanical symptoms in the knee, and are more prevalent amongst younger, more active patients, compared to degenerative tears amongst the elderly population. Traumatic meniscus tears typically result from the load-and-shear mechanism in the knee joint. The treatment depends on the size, location, and pattern of the tear. For non-repairable tears, partial or total meniscal resection decreases its tensile stress and increases joint contact stress, thus potentiating the risk of arthritis. A longitudinal vertical tear pattern at the peripheral third red-red zone leads to higher healing potential after repair. The postoperative rehabilitation protocols after repair range from immediate weight-bearing with no range of motion restrictions to non-weight bearing and delayed mobilization for weeks. Pediatric and adolescent patients may require special considerations due to their activity levels, or distinct pathologies such as a discoid meniscus. Further biomechanical and biologic evidence is needed to guide surgical management, postoperative rehabilitation protocols, and future technology applications for traumatic meniscus injuries.
摘要:
弯月面增加了膝盖中承载的接触面积,从而通过其圆周拉伸纤维分散了机械应力。创伤性半月板损伤会导致膝盖出现机械性症状,在年轻人中更普遍,更活跃的患者,与老年人群中退化的眼泪相比。创伤性半月板撕裂通常由膝关节中的负荷和剪切机制引起。治疗取决于大小,location,和眼泪的图案。对于不可修复的眼泪,半月板部分或全部切除可降低其拉应力并增加关节接触应力,从而增加关节炎的风险。在周边第三红区的纵向垂直撕裂模式导致修复后更高的愈合潜力。修复后的术后康复方案从没有运动范围限制的立即负重到无负重和延迟动员数周。儿科和青少年患者可能需要特殊考虑,因为他们的活动水平,或不同的病理,如盘状半月板。需要进一步的生物力学和生物学证据来指导手术治疗,术后康复方案,以及未来技术在创伤性半月板损伤中的应用。