A partial median meniscectomy, also known as a partial medial meniscectomy, is a surgical procedure that involves the removal of a portion of the meniscus, the crescent-shaped piece of cartilage located in the inner aspect of the knee joint. The meniscus acts as a shock absorber and helps to maintain the stability of the knee by distributing weight evenly across the joint surfaces. It can become damaged due to injury or as a result of normal wear and tear over time.
What is the meniscus?
The meniscus is made up of fibrocartilage and consists of two main parts: the meniscofemoral portion, located in the anterior and posterior aspects of the knee, and the meniscotibial portion, located between the medial and lateral tibiofemoral articulations. The meniscus acts as a crucial shock absorber, reducing the load on the articular cartilage. It also plays a vital role in the rotation and translation of the tibiofemoral joint as it moves through its full range of motion.
Why is the meniscus important?
The meniscus is important for several reasons:
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Shock Absorption: It helps to distribute weight evenly across the joint surfaces, reducing the risk of injury to the underlying bone.
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Stability: The meniscus maintains the stability of the knee joint by preventing excessive movement and providing support to the anterior and posterior cruciate ligaments.
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Nutrition: It acts as a nutrient channel, providing oxygen and nutrients to the articular cartilage.
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Joint润滑: The meniscus provides a thin layer of lubricating fluid that reduces wear on the articular cartilage.
What Happens During a Partial Meniscectomy?
A partial median meniscectomy is typically performed using an arthroscope, a thin, lighted tube with a camera that allows the surgeon to see the interior of the knee joint. Through small incisions, the surgeon can aid the arthroscope by manipulating surgical instruments. The meniscus is inspected for damage and the damaged portion is excised, ensuring that as much healthy meniscus tissue as possible is preserved.
What Are the Benefits of a Partial Meniscectomy?
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Pain Relief:切除受损的半月板组织可以减轻膝关节疼痛，尤其是对于那些半月板损伤严重影响到关节稳定性或者保守治疗无效的患者。
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Restoration of Function:手术可以帮助恢复膝关节的正常功能，包括活动度、稳定性和肌肉力量。根据文献综述，大约2/3的患者在手术后能够在3个月内恢复到正常的体育活动水平。
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Cost Efficieny:相比于完全切除半月板，部分切除是一种成本效益较高的手术方法。
3、风险和并发症：
- 感染风险：任何开放手术都有感染的风险，包括关节内感染。
2、麻醉相关风险：使用全身麻醉或局部麻醉都存在一定的风险
3、出血和肿胀：术后可能会出现肿胀和青紫。
4、血栓形成：手术后可能发生深静脉血栓形成或肺栓塞。
5、术后功能障碍：尽管大多数患者能够成功进行手术并返回工作，但有些人在手术后可能会经历持续性疼痛，特别是在某些特定的运动活动后，这可能会限制他们的活动水平。通常情况下，通过物理治疗、药物治疗和进一步的医疗干预来解决这个问题。