前交叉韧带重建术中半月板保留的当前策略
简介
这既是一篇面向ACL重建术中半月板保留策略的教育综述。文章总结常见伴发撕裂的处理要点：外侧半月板后根部撕裂采用经胫骨或锚钉修复，ramp lesion需系统探查并选择性修复，桶柄状及径向撕裂亦主张积极缝合。强调在稳定固定、个体化康复及良好力线与生物环境的基础上，保留半月板有助于改善预后并降低骨关节炎风险。
英文摘要
Meniscal preservation is a cornerstone of anterior cruciate ligament reconstruction (ACLR), reflecting the meniscus' critical role in joint homeostasis and long-term knee health. Concomitant meniscal injuries are common and increasingly managed with repair rather than resection. This educational review summarizes current strategies for the most frequent acute meniscal tears encountered during ACLR. Contemporary practice favors repair whenever feasible, supported by evidence linking meniscal preservation to improved outcomes and reduced osteoarthritis risk. Lateral meniscus posterior root tears are commonly managed with transtibial or anchor-based repair. Ramp lesions require systematic inspection and selective repair, with both all-inside and suture-based techniques yielding favorable results. Bucket-handle tears are repaired using all-inside, inside-out, or combined approaches depending on tear location, with high survival rates when performed alongside ACLR. Radial tears, particularly in vascular zones, should be repaired to restore hoop stress, although optimal suture configurations remain debated. Successful outcomes rely on mechanically stable repairs, individualized rehabilitation, knee stability and alignment, and a supportive biological environment.