内侧半月板突出：病因、诊断与治疗策略的叙述性综述
简介
本综述纳入85项研究，系统回顾内侧半月板突出的病因、诊断与治疗策略。半月板突出多源于后根部或退变性撕裂破坏环箍张力，并受半月板胫骨韧带、内翻力线及BMI等因素影响；相较单纯手术，联合力线矫正与半月板稳定术更能减少突出，但测量方法标准化仍是推动临床决策的关键。
英文摘要
OBJECTIVE: To comprehensively review recent developments in the etiology, imaging diagnosis, and treatment strategies for medial meniscal extrusion, highlighting biomechanical considerations and individualized therapeutic approaches. METHODS: We performed a narrative review of English-language clinical, imaging, and biomechanical studies by searching PubMed, Web of Science, and Embase from database inception to June 30, 2024, using terms related to meniscal extrusion, meniscal root tears, meniscotibial ligament injury, osteoarthritis, and corrective osteotomy, and we also screened reference lists of relevant reviews. Studies were included if they explicitly evaluated medial meniscal extrusion and reported quantitative extrusion assessment and/or its determinants, diagnostic performance, or treatment-related changes; we excluded studies not focused on medial extrusion, non-original articles without analyzable data, and reports lacking quantifiable extrusion outcomes. RESULTS: Eighty-five studies were included for qualitative synthesis. Current evidence indicates that medial meniscal extrusion most commonly arises from posterior root tears and degenerative tears that disrupt hoop tension, and is further amplified by meniscotibial ligament insufficiency, varus malalignment, increased body mass index, osteophytes, and subchondral insufficiency fracture, forming a self-reinforcing pathway of extrusion, compartment overload, cartilage loss, and subchondral bone changes. MRI remains the reference standard for static assessment, whereas ultrasound and weight-bearing protocols better capture load-dependent displacement; however, measurement planes, anatomical landmarks, and thresholds vary, limiting cross-study comparability. Across treatment studies, reported strategies ranged from structured nonoperative care to root repair, meniscal centralization, and high tibial osteotomy. In appropriately selected knees, studies evaluating combined biomechanical correction and meniscal stabilization more consistently reported measurable reductions in extrusion than isolated procedures, although outcome definitions and follow-up durations were heterogeneous. CONCLUSION: Medial meniscal extrusion is best understood as a mechano-structural failure state rather than an isolated imaging sign. Standardized measurement strategies and prospective comparative studies are needed to define actionable thresholds and refine patient-specific treatment pathways.