Meniscal Root Tears Significance, Diagnosis, and Treatment
Meniscal Root Tears Significance, Diagnosis, and Treatment
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DOI：
10.1177/0363546514524162
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发表时间：
2014-12-01
影响因子：
4.8
通讯作者：
LaPrade, Robert F.
中科院分区：
文献类型：
--
作者：
Bhatia, Sanjeev;LaPrade, Christopher M.;LaPrade, Robert F.
半月板根部撕裂不如半月板体部撕裂常见，且经常被忽视，它是半月板损伤的一种类型，常导致严重的膝关节疾病。半月板根部附着处通过将半月板固定在适当位置并使膝关节实现最佳减震功能，辅助半月板发挥作用。发生根部撕裂时，常常会出现半月板挤出，环向箍应力的传递也会受损。这改变了膝关节的生物力学和运动学，显著增加了胫股关节的接触压力。近年来，半月板根部撕裂（其定义包括从胫骨平台直接撕脱或根部本身附近的放射状撕裂）因人们担心严重的半月板挤出会极大地抑制正常的半月板功能，导致一种在生物力学上类似于半月板全切的状况而受到关注。近期文献强调了早期诊断和治疗的重要性；幸运的是，磁共振成像和关节镜技术的进步使这些过程得到了极大的改善。本文综述了半月板根部附着处临床相关的解剖学、生物力学和功能描述，以及目前对这些半月板根部附着处常见损伤的准确诊断和治疗策略。
Meniscal root tears, less common than meniscal body tears and frequently unrecognized, are a subset of meniscal injuries that often result in significant knee joint disorders. The meniscus root attachment aids meniscal function by securing the meniscus in place and allowing for optimal shock-absorbing function in the knee. With root tears, meniscal extrusion often occurs, and the transmission of circumferential hoop stresses is impaired. This alters knee biomechanics and kinematics and significantly increases tibiofemoral contact pressure. In recent years, meniscal root tears, which by definition include direct avulsions off the tibial plateau or radial tears adjacent to the root itself, have attracted attention because of concerns that significant meniscal extrusion dramatically inhibits normal meniscal function, leading to a condition biomechanically similar to a total meniscectomy. Recent literature has highlighted the importance of early diagnosis and treatment; fortunately, these processes have been vastly improved by advances in magnetic resonance imaging and arthroscopy. This article presents a review of the clinically relevant anatomic, biomechanical, and functional descriptions of the meniscus root attachments, as well as current strategies for accurate diagnosis and treatment of common injuries to these meniscus root attachments.