アブストラクト
| Title | スポーツ選手の半月板損傷 |
|---|---|
| Subtitle | 特集 : 下肢スポーツ損傷の診かた |
| Authors | 中村智祐*1, 古賀英之*2 |
| Authors (kana) | なかむらともまさ, こがひでゆき |
| Organization | *1東京医科歯科大学大学院医歯学総合研究科運動器外科学分野, 講師, *2教授 |
| Journal | MB Orthopaedics |
| Volume | 34 |
| Number | 2 |
| Page | 33-48 |
| Year/Month | 2021 / 2 |
| Article | 報告 |
| Publisher | 全日本病院出版会 |
| Abstract | 「Abstract」半月板障害はスポーツ選手のみならず, あらゆる年代において生じる膝関節の外傷・障害であり, また外科的治療を要する頻度も高い. 近年, 膝関節における半月板の荷重分散機能や膝関節のsecondary stabilizerとしての機能が再確認され, その重要性が広く認識されてきている. したがって半月板損傷の治療においては, 復帰を急ぐスポーツ選手に対するものであっても, できる限り半月板機能損失を低減する必要がある. 短期的な成績が良くても安易な切除は慎むべきである. 最善の治療を行うためには, 半月板の解剖を理解し, 損傷の部位・形態を正確に診断し, 適切な治療戦略を練る必要がある. また保存的・外科的治療どちらにおいても, 半月板の修復能・修復過程を考慮し, 行った治療に適した理学療法を, 各々の症例に応じて適用すべきである. 本稿では, 半月板損傷の理学所見・画像所見について述べ, また治療法として各種縫合・修復法を用いた半月板温存手術について述べる. |
| Practice | 臨床医学：外科系 |
| Keywords | 半月板(meniscus), スポーツ選手(athletes), 診断(diagnosis), 治療(treatment) |
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参考文献
- 1) Stanley LE, et al : Sex Differences in the Inci-dence of Anterior Cruciate Ligament, Medial Collateral Ligament, and Meniscal Injuries in Collegiate and High School Sports : 2009-2010 Through 2013-2014. Am J Sports Med. 44(6) : 1565-1572, 2016.
- 2) Mitchell J, et al : Epidemiology of meniscal inju-ries in US high school athletes between 2007 and 2013. Knee Surg Sports Traumatol Arthrosc. 24(3) : 715-722, 2016.
- 3) Minhas SV, et al : The Effect of an Orthopaedic Surgical Procedure in the National Basketball Association. Am J Sports Med. 44(4) : 1056-1061, 2016.
- 4) Musahl V, et al : The effect of medial versus lateral meniscectomy on the stability of the anterior cruciate ligament-deficient knee. Am J Sports Med. 38(8) : 1591-1597, 2010.
- 5) Nakamura T, et al : Arthroscopic centralization restores residual knee laxity in ACL-recon-structed knee with a lateral meniscus defect. Knee Surg Sports Traumatol Arthrosc. 2019.
残りの35件を表示する
- 6) Lubowitz JH, et al : Save the meniscus. Arthro-scopy. 27(3) : 301-302, 2011.
- 7) Malanga GA, et al : Physical examination of the knee : a review of the original test description and scientific validity of common orthopedic tests. Arch Phys Med Rehabil. 84(4) : 592-603, 2003.
- 8) Galli M, et al : Accuracy of McMurray and Joint Line Tenderness Tests in the Diagnosis of Chronic Meniscal Tears : An Ad Hoc Receiver Operator Characteristic Analysis Approach. Arch Phys Med Rehabil. 98(9) : 1897-1899, 2017.
- 9) Kurosaka M, et al : Efficacy of the axially loaded pivot shift test for the diagnosis of a meniscal tear. Int Orthop. 23(5) : 271-274, 1999.
- 10) Mink JH, et al : Magnetic resonance imaging of the knee. Clin Orthop Relat Res. 244 : 29-47, 1989.
- 11) Wadhwa V, et al : ISAKOS classification of meniscal tears-illustration on 2D and 3D iso-tropic spin echo MR imaging. Eur J Radiol. 85(1) : 15-24, 2016.
- 12) Magee TH, et al : MRI of meniscal bucket-handle tears. Skeletal Radiol. 27(9) : 495-499, 1998.
- 13) LaPrade CM, et al : Meniscal root tears : a clas-sification system based on tear morphology. Am J Sports Med. 43(2) : 363-369, 2015.
- 14) Furumatsu T, et al : A giraffe neck sign of the medial meniscus : A characteristic finding of the medial meniscus posterior root tear on magnetic resonance imaging. J Orthop Sci. 22(4) : 731-736, 2017.
- 15) Feucht MJ, et al : Posterior root tears of the lateral meniscus. Knee Surg Sports Traumatol Arthrosc. 23(1) : 119-125, 2015.
- 16) Krych AJ, et al : High Rate of Missed Lateral Meniscus Posterior Root Tears on Preopera-tive Magnetic Resonance Imaging. Orthop J Sports Med. 6(4) : 2325967118765722, 2018.
- 17) MinamiT, et al : Lateral meniscus posterior root tear contributes to anterolateral rotational instability and meniscus extrusion in anterior cruciate ligament-injured patients. Knee Surg Sports Traumatol Arthrosc. 26(4) : 1174-1181, 2018.
- 18) Kumar NS, et al : Is Edema at the Posterior Medial Tibial Plateau Indicative of a Ramp Lesion? An Examination of 307 Patients With Anterior Cruciate Ligament Reconstruction and Medial Meniscal Tears. Orthop J Sports Med. 6(6) : 2325967118780089, 2018.
- 19) DePhillipo NN, et al : Incidence and Detection of Meniscal Ramp Lesions on Magnetic Reso-nance Imaging in Patients With Anterior Cru-ciate Ligament Reconstruction. Am J Sports Med. 45(10) : 2233-2237, 2017.
- 20) Liu X, et al : Arthroscopic prevalence of ramp lesion in 868 patients with anterior cruciate ligament injury. Am J Sports Med. 39(4) : 832-837, 2011.
- 21) Ahn JH, et al : A novel magnetic resonance imaging classification of discoid lateral menis-cus based on peripheral attachment. Am J Sports Med. 37(8) : 1564-1569, 2009.
- 22) Dai H, et al : Diagnostic accuracy of ultrasonog-raphy in assessing meniscal injury : meta-analysis of prospective studies. J Orthop Sci. 20(4) : 675-681, 2015.
- 23) Chiba D, et al : Meniscal extrusion seen on ultrasonography affects the development of radiographic knee osteoarthritis : a 3-year pro-spective cohort study. Clin Rheumatol. 36(11) : 2557-2564, 2017.
- 24) Tengrootenhuysen M, et al : Long-term out-come after meniscal repair. Knee Surg Sports Traumatol Arthrosc. 19(2) : 236-241, 2011.
- 25) 田中哲平ほか : 外側半月単独損傷に対する関節鏡視下半月縫合術の試合復帰と術後成績についての検討. JOSKAS. 43(4) : 384, 2018.
- 26) Zhang AL, et al : Tibiofemoral contact pres-sures in radial tears of the meniscus treated with all-inside repair, inside-out repair and partial meniscectomy. Knee. 22(5) : 400-404, 2015.
- 27) Fox AJ, et al : The basic science of human knee menisci : structure, composition, and function. Sports Health. 4(4) : 340-351, 2012.
- 28) Paxton ES, et al : Meniscal repair versus partial meniscectomy : a systematic review compar-ing reoperation rates and clinical outcomes. Arthroscopy. 27(9) : 1275-1288, 2011.
- 29) Chahla J, et al : Meniscal Repair With Fibrin Clot Augmentation. Arthrosc Tech. 6(6) : e2065-e2069, 2017.
- 30) Griffin JW, et al : Platelet-rich plasma in menis-cal repair : does augmentation improve surgi-cal outcomes? Clin Orthop Relat Res. 473(5) : 1665-1672, 2015.
- 31) Dai WL, et al : Efficacy of platelet-rich plasma in arthroscopic repair for discoid lateral menis-cus tears. BMC Musculoskelet Disord. 20(1) : 113, 2019.
- 32) Kijowski R, et al : Arthroscopic partial menis-cectomy : MR imaging for prediction of out-come in middle-aged and elderly patients. Radiology. 259(1) : 203-212, 2011.
- 33) Nasu H, et al : An anatomic study on the attachment of the joint capsule to the tibia in the lateral side of the knee. Surg Radiol Anat. 40(5) : 499-506, 2018.
- 34) Berthiaume MJ, et al : Meniscal tear and extru-sion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis. 64(4) : 556-563, 2005.
- 35) Lee DH, et al : Predictors of degenerative medial meniscus extrusion : radial component and knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 19(2) : 222-229, 2011.
- 36) Choi NH : Radial displacement of lateral menis-cus after partial meniscectomy. Arthroscopy. 22(5) : 575 e1-4, 2006.
- 37) Koh YG, et al : Comparison of medial and lat-eral meniscal transplantation with regard to extrusion of the allograft, and its correlation with clinical outcome. J Bone Joint Surg Br. 94(2) : 190-193, 2012.
- 38) Koga H, et al : Arthroscopic centralization of an extruded lateral meniscus. Arthrosc Tech. 1(2) : e209-212, 2012.
- 39) Koga H, et al : Two-Year Outcomes After Arthroscopic Lateral Meniscus Centralization. Arthroscopy. 32(10) : 2000-2008, 2016.
- 40) An JS, et al : Osteochondral lesion of lateral tibial plateau with extrusion of lateral menis-cus treated with retrograde osteochondral autograft transplantation and arthroscopic cen-tralisation. Asia Pac J Sports Med Arthrosc Rehabil Techno. 8 : 18-23, 2017.
