Arthroscopic meniscal repair with fibrin clot of complete radial tears of the lateral meniscus in the avascular zone
Arthroscopic meniscal repair with fibrin clot of complete radial tears of the lateral meniscus in the avascular zone
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DOI：
10.1016/s0749-8063(98)70002-7
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发表时间：
1998-05-01
期刊：
影响因子：
4.7
通讯作者：
Wickiewicz, TL
中科院分区：
文献类型：
--
作者：
van Trommel, MF;Simonian, PT;Wickiewicz, TL
关节镜下外侧韧带撕裂可进行修复。然而，邻近腘肌腱的外侧半月板后外侧缺乏穿透性外周血管，因此难以愈合。此部位的完全性桡骨劈裂通常采用全椎板切除术治疗。我们报告五个病例的撕裂后外侧方面的外侧半月板前方的腘窝。所有患者的桡骨裂开延伸至腘肌腱。在所有情况下，修复增强了纤维蛋白凝块。二次关节镜检查显示，所有病例均发生了外周愈合。所有患者均恢复到最初的运动水平，5名患者中有3名可接受平均71个月的随访，当时进行磁共振成像以评估先前修复的半月板。所有半月板均完全愈合，没有进一步的退化迹象。外源性纤维蛋白凝块刺激和支持半月板无血管部分的修复反应的能力可能是一种潜在的修复方法。认识到该区域相对较低的愈合潜力并增加愈合机会应能改善结局。
Peripheral lateral meniscal tears are amenable to arthroscopic meniscal repair. However, the posterolateral aspect of the lateral meniscus adjacent to the popliteus tendon is devoid of penetrating peripheral vessels and therefore difficult to heal. A complete radial split at this site is usually treated with total meniscectomy. We report ve cases of a tear of the posterolateral aspect of the lateral meniscus anterior to the popliteus fossa. All patients had a radial split that extended to the popliteus tendon. In all cases, the repair was enhanced with a fibrin clot. Second-look arthroscopy showed that healing of the periphery occurred in all of the cases. All patients returned to their initial level of sports activity, Three of five patients were available for follow-up at an average of 71 months, and magnetic resonance imaging was performed at that time to assess the previously repaired meniscus. All menisci were fully healed and showed no further signs of degeneration The ability of an exogenous fibrin clot to stimulate and support a reparative response in the avascular portion of the meniscus may represent a potential method of repair. Awareness of the relatively low healing potential of this zone and enhancement of healing opportunities should improve outcome.