半月板放射状撕裂的国际德尔菲共识：从诊断到治疗与康复
简介
一项国际德尔菲共识（45名国际骨科医生）就半月板放射状撕裂（MRT）的诊断、非手术管理、手术指征/技术及康复形成推荐。共识支持修复孤立急性创伤性及伴急性交叉韧带损伤的MRT；慢性退变性撕裂需依据半月板组织质量和骨关节炎程度决定，年龄本身非禁忌，部分半月板切除长期有害。成功修复强调解剖恢复并处理周边延伸和间隙，术后建议初始非负重康复；证据级别V级专家意见。
英文摘要
PURPOSE: To establish consensus statements on risk factors, diagnosis, nonoperative management, surgical indications and techniques, rehabilitation strategies, and clinical and functional outcomes of meniscus radial tears (MRT). METHODS: A working group of fellowship-trained sports medicine surgeons developed original statements based on a review of the current literature on MRT. A panel of 45 international orthopaedic surgeons was surveyed. Agreement with each statement was assessed using a 5-point Likert scale, and statements were retained, revised, or excluded according to predefined thresholds (≥80% agreement and <20% disagreement). Expert-suggested revisions and additional statements generated during the first 2 rounds were further reviewed and voted on in the final round 3. RESULTS: The expert panel achieved consensus on repair for isolated acute traumatic MRTs and those associated with acute cruciate ligament injuries, whereas repair in chronic degenerative tears should be based on meniscal tissue quality and degree of osteoarthritis. Although partial meniscectomy may provide short-term relief, its long-term detrimental effects should not be underestimated. Increased age alone was not considered a risk factor for MRT repair. Successful healing requires addressing peripheral extension and gapping, with anatomic restoration prioritized over surgical technique or suture choice. Given limited evidence on early weightbearing and unrestricted motion, a conservative postoperative protocol is advised. No repair technique has proven superior with choice guided by surgeon preference. CONCLUSIONS: Expert consensus supports repair of acute traumatic and acute cruciate ligament-associated MRTs, whereas indications for chronic degenerative tears depend on tissue quality and joint status. Increased age alone was not considered a contraindication to MRT repair. Anatomic restoration is essential for a successful outcome, irrespective of surgical technique. An initial nonweight-bearing rehabilitation protocol is recommended. LEVEL OF EVIDENCE: Level V, expert opinion, modified Delphi consensus.