Research progress of knee meniscal repair techniques_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

FENG Jianhao ¹ , XU Yihong ² ,  XU Weidong ²

1. Department of Orthopaedics, Tongji Hospital, Tongji University, Shanghai, 200065, P. R. China;
2. Department of Joint Surgery, the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Shanghai, 200433, P. R. China;

Corresponding author：

XU Weidong, Email: xuwdshanghai@126.com

Keywords：

Knee; meniscus; meniscectomy; meniscal repair

DOI：

10.7507/1002-1892.202302103

Video：

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Objective To review the research progress of meniscus repair in recent years, in order to provide help for the clinical decision-making of meniscus injury treatment. Methods The domestic and foreign literature related to meniscal repair in recent years was extensively reviewed to summarize the reasons for the prevalence of meniscal repair, surgical indications, various repair methods and long-term effectiveness, the need to deal with mechanical structural abnormalities, biological enhancement repair technology, rehabilitation treatment, and so on. Results In order to delay the occurrence of osteoarthritis, the best treatment of meniscus has undergone an important change from partial meniscectomy to meniscal repair, and the indications for meniscal repair have been expanding. The mid- and long-term effectiveness of different meniscal repair methods are ideal. During meniscus repair, the abnormality of lower limb force line and meniscus protrusion should be corrected at the same time. There are controversies about the biological enhancement technology to promote meniscus healing and rehabilitation programs, which need further study. Conclusion Meniscal repair can restore the normal mechanical conduction of lower limbs and reduce the incidence of traumatic osteoarthritis, but the poor blood supply and healing ability of meniscal tissue bring difficulties to meniscal repair. Further development of new biological enhanced repair technology and individualized rehabilitation program and verification of its effectiveness will be an important research direction.

Citation： FENG Jianhao, XU Yihong, XU Weidong. Research progress of knee meniscal repair techniques. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(7): 885-894. doi: 10.7507/1002-1892.202302103 Copy

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1. 冯子嫣, 樊逸菲, 郭玖思, 等. 组织工程半月板支架材料的研究进展. 中国修复重建外科杂志, 2019, 33(8): 1019-1028.
2. Li Z, Wu N, Cheng J, et al. Biomechanically, structurally and functionally meticulously tailored polycaprolactone/silk fibroin scaffold for meniscus regeneration. Theranostics, 2020, 10(11): 5090-5106.
3. Twomey-Kozak J, Jayasuriya CT. Meniscus repair and regeneration: A systematic review from a basic and translational science perspective. Clin Sports Med, 2020, 39(1): 125-163.
4. 买买提克里木·吐松江, 贾勇, 许刚, 等. 关节镜下全内联合外-内 “环抱” 式缝合法治疗半月板桶柄样撕裂疗效观察. 中国修复重建外科杂志, 2020, 34(10): 1238-1242.
5. 刘守东, 谢洪彬, 单森, 等. 关节镜自动反向导引过线器在半月板后根重建中的应用研究. 中国修复重建外科杂志, 2022, 36(3): 291-295.
6. Bansal S, Floyd ER, A Kowalski M, et al. Meniscal repair: The current state and recent advances in augmentation. J Orthop Res, 2021, 39(7): 1368-1382.
7. Petersen W, Karpinski K, Bierke S, et al. A systematic review about long-term results after meniscus repair. Arch Orthop Trauma Surg, 2022, 142(5): 835-844.
8. Arnoczky SP, Warren RF. The microvasculature of the meniscus and its response to injury. An experimental study in the dog. Am J Sports Med, 1983, 11(3): 131-141.
9. Baratz ME, Fu FH, Mengato R. Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report. Am J Sports Med, 1986, 14(4): 270-275.
10. 朱泽, 姚志华, 邱志汝, 等. 半月板损伤缝合修补术的生物力学依据. 中国骨与关节损伤杂志, 2019, 34(12): 1320-1322.
11. Fairbank TJ. Knee joint changes after meniscectomy. J Bone Joint Surg (Br), 1948, 30b(4): 664-670.
12. Hulet C, Menetrey J, Beaufils P, et al. Clinical and radiographic results of arthroscopic partial lateral meniscectomies in stable knees with a minimum follow up of 20 years. Knee Surg Sports Traumatol Arthrosc, 2015, 23(1): 225-231.
13. Muriuki MG, Tuason DA, Tucker BG, et al. Changes in tibiofemoral contact mechanics following radial split and vertical tears of the medial meniscus an in vitro investigation of the efficacy of arthroscopic repair. J Bone Joint Surg (Am), 2011, 93(12): 1089-1095.
14. Lutz C, Dalmay F, Ehkirch FP, et al. Meniscectomy versus meniscal repair: 10 years radiological and clinical results in vertical lesions in stable knee. Orthop Traumatol Surg Res, 2015, 101(8 Suppl): S327-S331.
15. Arner JW, Ruzbarsky JJ, Vidal AF, et al. Meniscus repair part 2: Technical aspects, biologic augmentation, rehabilitation, and outcomes. J Am Acad Orthop Surg, 2022, 30(13): 613-619.
16. Hutchinson ID, Rodeo SA. The Current role of biologics for meniscus injury and treatment. Curr Rev Musculoskelet Med, 2022, 15(6): 456-464.
17. Kopf S, Beaufils P, Hirschmann MT, et al. Management of traumatic meniscus tears: the 2019 ESSKA meniscus consensus. Knee Surg Sports Traumatol Arthrosc, 2020, 28(4): 1177-1194.
18. Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med, 1982, 10(2): 90-95.
19. Barber-Westin SD, Noyes FR. Clinical healing rates of meniscus repairs of tears in the central-third (red-white) zone. Arthroscopy, 2014, 30(1): 134-146.
20. Beaufils P, Hulet C, Dhénain M, et al. Clinical practice guidelines for the management of meniscal lesions and isolated lesions of the anterior cruciate ligament of the knee in adults. Orthop Traumatol Surg Res, 2009, 95(6): 437-442.
21. Patel NM, Mundluru SN, Beck NA, et al. Which factors increase the risk of reoperation after meniscal surgery in children? Orthop J Sports Med, 2019, 7(5): 2325967119842885. doi: 10.1177/2325967119842885.
22. Rubman MH, Noyes FR, Barber-Westin SD. Arthroscopic repair of meniscal tears that extend into the avascular zone. A review of 198 single and complex tears. Am J Sports Med, 1998, 26(1): 87-95.
23. Cinque ME, DePhillipo NN, Moatshe G, et al. Clinical outcomes of inside-out meniscal repair according to anatomic zone of the meniscal tear. Orthop J Sports Med, 2019, 7(7): 2325967119860806. doi: 10.1177/2325967119860806.
24. Terzidis IP, Christodoulou A, Ploumis A, et al. Meniscal tear characteristics in young athletes with a stable knee: arthroscopic evaluation. Am J Sports Med, 2006, 34(7): 1170-1175.
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Chinese Journal of Reparative and Reconstructive Surgery

Research progress of knee meniscal repair techniques

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