修订前交叉韧带手术中的半月板病理：特殊考量
简介
翻修前交叉韧带重建术（RACLR）中，半月板病变常见且更具挑战性，因初次手术可能已损伤组织质量。移植物失效显著增加半月板撕裂发生率，且常导致广泛、复杂甚至不可修复的撕裂。半月板保留策略有助于恢复膝关节解剖与生物力学，可能延缓骨关节炎进展。临床处理需根据撕裂类型、组织质量和关节环境个体化决策，优先考虑修复而非切除，以改善长期预后。
英文摘要
PURPOSE OF REVIEW: Similar to primary anterior cruciate ligament reconstruction (ACLR), meniscal pathology is frequently encountered during revision ACLR (RACLR). In the revision setting, however, meniscal disease often presents a greater challenge because tissue quality may be compromised, particularly when prior meniscal treatment was performed at the index ACLR. This review highlights key considerations and treatment strategies for managing extensive, complex meniscal lesions in the setting of RACLR. RECENT FINDINGS: Graft failure significantly increases the incidence of meniscal tears. Furthermore, graft insufficiency may result in extensive, complex, and sometimes, irreparable meniscal tears. Meniscal treatment strategies, and ultimately joint preservation, have been studied to restore appropriate knee anatomy and biomechanics. Furthermore, special considerations must be made to best treat a wide range of meniscal pathologies in the RACLR, especially in a suboptimal joint environment. Graft failure requiring revision ACL reconstruction is often accompanied by extensive, complex meniscal tearing. Meniscus-preserving strategies may help restore knee anatomy and biomechanics and, in turn, may slow the progression of osteoarthritis.