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外侧半月板后角斜形放射状撕裂的临床研究进展

Research progress on posterior horn lateral meniscus oblique radial tear

摘要目的:总结外侧半月板后角斜形放射状撕裂(LMORT)的临床研究进展。方法:在中国知网、万方、PubMed、Web of Science、Google Scholar数据库中,检索2024年3月之前公开发表的关于LMORT的临床研究文献76篇(中文文献5篇、英文文献71篇)。剔除内容侧重于并发的前交叉韧带(ACL)撕裂、内容重复或相近,以及无法获取全文的文献,最终纳入37篇文献进行分析,对LMORT的定义与诊断、分类、发病率、生物力学、治疗及预后等相关临床研究的进展进行归纳总结。结果:LMORT是急性ACL损伤最常伴随的一种外侧半月板撕裂,发病率较高,对膝关节生物力学有严重的不利影响,可破坏膝关节稳定性、加速膝关节炎发生。关节镜检查结果是LMORT诊断和分类的金标准。目前已构建针对LMORT的分类系统,临床根据LMORT的分型进行针对性的治疗可改善患者的预后,但当前的分类系统还存在缺陷。LMORT患者的治疗以手术为主,加速LMORT愈合新技术的应用有望改善患者的预后。结论:LMORT是近年发现的一类急性ACL撕裂伴随的外侧半月板撕裂损伤,由于相关的研究有限,其分类系统还有待完善,需要更多高质量的研究成果使患者从中获益。

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abstractsObjective:This study aimed to summarize the advances in clinical research on posterior horn lateral meniscus oblique radial tear (LMORT).Methods:A computer-based online search was conducted in the databases of CNKI, Wanfang Data, PubMed, Web of Science, and Google Scholar to identify articles involving clinical research on posterior horn LMORT that were published before March 2024. A total of 76 articles (5 articles in Chinese and 71 articles in English) were retrieved. The exclusion focused on the literatures with concurrent anterior cruciate ligament (ACL) tears, overlapping or similar contents, and unable to obtain the full text. Finally, 37 articls were included for analysis, and the research progress on the definition, diagnosis, classification, incidence, biomechanics, treatment, and prognosis of LMORT was summarized.Results:LMORT is the most common type of lateral meniscus tear associated with acute anterior cruciate ligament (ACL) injuries. The incidence of posterior horn LMORT accompanied with acute ACL injuries is high. Posterior horn LMORT has serious adverse effects on knee biomechanics, resulting in knee instability and accelerated knee osteoarthritis. Arthroscopy is the gold standard in the diagnosis of LMORT. A classification system for LMORT has been established to diagnose the type of LMORT and choose the corresponding treatment for improving the patient's prognosis. In the future, clinical prognosis will be further improved by new techniques to enhance LMORT healing. However, the current classification system has flaws. Surgery is the main treatment for LMORT, and the application of new techniques to accelerate the healing of LMORT is expected to further improve the prognosis of patients.Conclusions:LMORT is a kind of lateral meniscus tear associated with acute ACL tear that has been discovered in recent years, but limited studies have been conducted on LMORT. LMORT's classification system needs to be improved, and additional high-quality research results are needed to benefit patients.

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