The Healing of Semilunar Cartilages
The Healing of Semilunar Cartilages
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半月软骨的愈合
DOI：
10.1097/00003086-199003000-00002
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发表时间：
1936
影响因子：
4.2
通讯作者：
J. J. Niebauer
中科院分区：
文献类型：
--
作者：
D. King;J. J. Niebauer
在犬的7个膝关节中，内侧半月软骨在不同程度上从其与滑膜和关节囊的附着处周围游离。几天之内，狗以正常的方式行走和奔跑;没有产生关节锁定。一段时间后（两周到三个半月），处死动物并检查关节。在每种情况下，软骨在正常解剖位置牢固愈合。
在13个关节中，半月软骨被纵向切开。在每种情况下，切口不与滑膜相通，并且其在软骨中的位置不同。除了一只例外（犬14），尽管未使用术后固定，但半月软骨的两个碎片仍然紧密贴壁。尽管如此紧密贴壁，但在观察期间（3周至2个月），碎片之间没有任何愈合迹象。
在7个关节中，纵向切口通过半月板的凸面边缘到达滑膜。在每例病例中，切口的外周端均由滑膜和关节囊产生的结缔组织愈合。在一种情况下（犬3），整个切口充满瘢痕组织。
当半月软骨被横向分开时（在六个关节中），两个碎片被分开一小段距离。由此产生的自由空间被滑膜内长的结缔组织所消除，将两个碎片牢固地连接在一起。这种结缔组织与纤维软骨非常相似，但不含软骨细胞。
我们的实验表明：
1.局限于半月软骨的撕裂可能永远不会愈合。
2.如果撕裂处与滑膜横向相通，则半月板撕裂可通过结缔组织愈合。
3.完全的横向或斜向撕裂导致骨折块分离，但间隙被滑膜产生的结缔组织填充。这种结缔组织在三周内相当牢固，这表明在这些病例中完全固定所需的时间长度。
4.如果半月板从其周边附着处部分撕裂，则其在正常解剖位置愈合没有困难。
In seven knee joints of dogs, the internal semilunar cartilages were freed, to a varying extent, from their attachments to the synovial membrane and capsule peripherally. Within a few days, the dogs walked and ran about in a normal way; no locking of the joints was produced. After a period of time (two weeks to three and a half months), the animals were sacrificed and the joints were examined. In each case, the cartilage was firmly healed in normal anatomical position.
In thirteen joints, the semilunar cartilages were incised longitudinally. In each case the incision did not communicate with the synovial membrane and varied in its position in the cartilage. With one exception (Dog 14), the two fragments of the semilunar cartilages remained closely apposed although no postoperative fixation was used. In spite of this close apposition, there was not the slightest evidence of healing between the fragments during the period of observation (three weeks to two months).
In seven joints, the longitudinal incision was carried through the convex edge of the meniscus to the synovial membrane. In each case, the peripheral end of the incision healed by connective tissue arising from the synovial membrane and capsule. In one instance (Dog 3), the entire incision was filled with scar tissue.
When the semilunar cartilage was divided transversely (in six joints), the two fragments were separated a short distance. The free space thus produced was obliterated by an ingrowth of connective tissue from the synovial membrane, linking the two fragments firmly together. This connective tissue, which grossly resembled fibrocartilage, contained no cartilage cells.
Our experiments indicate that:
1. Tears which are limited to the semilunar cartilage probably never heal.
2. A torn meniscus can be healed by connective tissue if the tear communicates with the synovial membrane laterally.
3. A complete transverse or oblique tear results in some separation of the fragments, but the intervening space fills in with connective tissue arising from the synovial membrane. This connective tissue is quite firm in three weeks, which suggests the length of time necessary for complete fixation in these cases.
4. If the meniscus is partially torn from its peripheral attachment, it heals in normal anatomical position without difficulty.