衰老半月板：病理生理学、流行病学与治疗
简介
半月板是负责载荷分布、减震和维持膝关节稳定的纤维软骨结构。随着年龄增长，其生物力学和生化完整性因细胞衰老、晚期糖基化终末产物累积、血供减少及胶原交联改变而逐渐下降。这些变化易导致结构损伤，最常见的是水平状劈裂——这是半月板老化的标志性改变，应理解为半月板的“皱纹”而非真正病理。此类损伤在MRI上常无症状且为偶然发现，但部分患者可能出现疼痛或机械症状，需要针对…
英文摘要
The meniscus is a fibrocartilaginous structure crucial for load distribution, shock absorption and knee stability. With advancing age, its biomechanical and biochemical integrity declines through progressive cellular senescence, accumulation of advanced glycation end-products, reduced vascularity and altered collagen cross-linking. These changes predispose to structural damage most often seen as horizontal cleavage lesions-the hallmark of meniscal ageing-best understood as 'wrinkles' of the meniscus rather than true pathology. Such lesions are often asymptomatic and incidental on MRI. However, in some individuals they may cause pain or mechanical symptoms requiring targeted, conservative management. This narrative review integrates biological, epidemiological and clinical data to provide an evidence-based framework for managing the ageing meniscus. We discuss the natural history of degenerative lesions and detail practical strategies for orthopaedic clinicians, including exercise therapy, metabolic optimization, nutritional supplementation, biomechanical offloading and injection-based interventions. Surgical treatment should remain a second-line option, reserved for patients with persistent symptoms or biomechanically significant lesions.