膝关节半月板损伤的修复：异种异体及组织工程半月板移植替代治疗

Meniscus injury repair by xenogenic or tissue-engineered meniscus replacement therapy

背景:半月板在膝关节运动性损伤中十分常见,因其血供特点,严重的半月板毁损性损伤治疗一直是临床的难题。如何有效修复半月板损伤防止后期膝关节骨性关节炎的发生,是很多学者一直努力解决的问题。目的:就半月板损伤修复及严重半月板破裂损伤移植替代治疗情况进行综述。方法:由第一作者检索中国知网(www.cnki.net)及Medline数据库(www.pubmed.com)2000-01/2009-03有关半月板损伤修复及严重半月板破裂损伤移植替代治疗的文章,中文检索词为"半月板,修复,移植替代治疗",英文检索词为"meniscus,repair,ransplanted replacement therapy"。排除研究目的与课题无关的文章以及重复研究,最后纳入29篇文献作进一步分析。结果与结论:目前半月板损伤治疗方法多种多样,严格掌握适应证,选择适当的半月板修复方法显得尤其重要。异种异体半月板移植及组织工程半月板修复为半月板缺损尤其是无血管区的修复开辟了新的途径,然而此两种方法尚需在免疫学、流行病学、解剖学、生物力学及临床效果等方面加以研究验证。

BACKGROUND：Meniscus injury is a common sports injury of knee joint.Severe meniscus injury is difficult for clinical treatment due to the blood supply features.Effective repair of meniscus injury can prevent osteoarthritis of knee joint.OBJECTIVE：To review meniscus injury repair and transplantation replacement treatment of meniscus injury.METHODS：A computer-based online search of CNKI（www.cnki.net）and Medline database（www.pubmed.com）was performed for related articles published between January 2000 and March 2009,with the Keywords＂meniscus,repair,transplanted replacement therapy＂ in Chinese and English.Unrelated and repetitive studies were excluded.A total of 29 articles were included.RESULTS AND CONCLUSION：There are a number of treatment for meniscus injury,and indications and appropriate repair methods are very important.Xenogenic meniscus transplantation and tissue-engineered meniscus provide novel approach for meniscus injury repair,in particular the repair of avascular zone.However,the two methods require validation of immunology,epidemiology,anatomy,biomechanics,and clinical effect.