ISSN:1062-8592    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Understanding the natural history of the post-meniscectomy knee and having an appreciation for factors that influence surgical outcome enable the surgeon to individualize patient treatment and optimize results. This article reviews the various biomechanical changes in the knee after meniscectomy. There is a resultant increase in tibiofemoral contact forces proportional to the amount of tissue removed, and an alteration in knee kinematics. Clinical studies that characterized the results after meniscectomy in terms of patient functional outcome and radiographic changes are also reviewed. Several studies have demonstrated that results after meniscectomy are negatively influenced by pre-existing osteoarthritis, chondral damage, anterior cruciate ligament deficiency or other significant ligament injury, extent and location of meniscectomy (lateral vs. medial), type of meniscal tear (degenerative vs. traumatic), and knee malalignment. However, there is no definitive correlation between gender and age and surgical outcome after partial meniscectomy, provided that the knee has no other concomitant pathology.

ISSN:1062-8592    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The high incidence of knee osteoarthritis (OA) after meniscectomy, combined with the serious burden caused by the disease, warrants the need for treatments that focus on attempts to prevent or delay the progression of OA after this common procedure. The purpose of this paper is to review nonsurgical management strategies after meniscectomy. When reviewing such strategies, we emphasize outlining the normal role of the meniscus and finding potential methods of reproducing those functions through alternate techniques. We consider knee braces and shoe wedges, as they may reduce the external moments about the knee, decrease compartment loads, and improve the symptoms associated with OA. We also describe low-impact training programs with foci on proprioception, postural control, and muscular strength.

ISSN:1062-8592    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Loss of the meniscus decreases contact area, resulting in increased stress on the articular cartilage of the knee. Osteoarthritis frequently develops and sclerotic bone is exposed on the articular surfaces of the joint. In the medial compartment, this process is characterized by loss of articular cartilage and anterior cruciate ligament and medial cruciate ligament laxity in the extension gap, with no corresponding laxity in the flexion gap. This focal articular and ligamentous imbalance may persist for a decade or more. Minimally invasive unicondylar arthroplasty is a low-morbidity procedure that resurfaces the medial compartment and rebalances ligaments while preserving bone for future arthroplasty procedures.

ISSN:1062-8592    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Unicompartmental arthroplasty of the knee has become an accepted treatment alternative for limited osteoarthritis of the knee. Clinical studies are helping to determine which patients with unicompartmental arthritis of the knee have the most to gain from the limited nature of this surgery. The medium-term clinical results of properly selected patients are comparable to those of total knee arthroplasty. The small components used lend themselves to minimally invasive surgery.The Oxford unicompartmental arthroplasty has been developed to solve the problem of the kinematic conflict in knee arthroplasty design. The two separate articulating surfaces allow for simultaneous high congruency of both articulations while allowing the natural sliding motion in the sagittal plane. Strict attention to surgical technique and patient selection can help to achieve excellent arthroplasty longevity with high patient satisfaction.

ISSN:1062-8592    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The management of meniscal tears is still evolving. As recently as 20 years ago, many meniscal tears were treated with complete excision. With the growing appreciation for meniscal function, management has progressed to partial meniscectomy, meniscal repair, and meniscal transplant to preserve as much of the meniscus as possible. The decision to perform a meniscal repair depends on the patience and technical expertise of the surgeon and on certain properties of the tear itself. Many surgeons are now performing meniscal repairs on tears of defined patterns and locations in a subset of patients; however, many tears are still treated with partial excision. This article explores the current indications for meniscal repairs and how some surgeons are broadening these indications.

ISSN:1062-8592    

出版商:OVID    

年代:2002

数据来源: OVID