Meniscus Tear Management: Indications, Technique, and Outcomes.

Autor:	Hevesi M; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A., Krych AJ; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A., Kurzweil PR; Memorial Orthopaedic Surgical Group, Long Beach, California, U.S.A.. Electronic address: pkurzweil@aol.com.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2019 Sep; Vol. 35 (9), pp. 2542-2544.
DOI:	10.1016/j.arthro.2019.07.013
Abstrakt:	Meniscus tears are commonly encountered in the clinical and operative setting and vary in presentation, including bucket-handle, radial, and horizontal cleavage tears. Historically, tears were treated with benign neglect or partial meniscectomy. However, a great deal of subsequent research has highlighted the biomechanical consequences of tears and meniscectomy, including increased peak local contact forces, progressive postmeniscectomy arthritis, and subsequent arthroplasty. With the advent and evolution of repair devices, increasing attention is being turned to the ideal restorative treatment of meniscus tears. Successful meniscus repair is centered about the ABCs of repair: Anatomic reduction, Biologic preparation and augmentation, and Circumferential compression. Recent advances in repair techniques have included microfracture of the intercondylar notch to provide healing factors and marrow cells for augmented healing, all-inside suture devices enabling the reduction and fixation tears without the need for additional assistants and the morbidity of inside-out exposure, and circumferential compression combined with clot augmentation to reduce and fix horizontal cleavage tears and recreate biomechanics to within 15% of baseline contact forces. Clinical outcomes of meniscus repair using modern techniques have been promising, with reapproximation of native joint biomechanics, substantial improvements in patient subjective outcome scores, and satisfactory reoperation rates. With implementation of the ABCs of meniscus repair as well as the continued expansion of the orthopedic surgeons' meniscus repair toolbox, restoration and preservation of the meniscus are increasingly possible across the spectrum of tear types. (Copyright © 2019 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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