The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. With vascular penetration of less than onethird of the adult meniscus, healing potential in the settin...The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. With vascular penetration of less than onethird of the adult meniscus, healing potential in the setting of chronic degeneration remains low. Continued hoop and shear stresses upon the degenerative meniscus results in gross failure, often in the form of complex tears in the posterior horn and midbody. Patient history and physical examination are critical to determine the true source of pain, particularly with the significant incidence of simultaneous articular pathology. Joint line tenderness, a positive Mc Murray test, and mechanical catching or locking can be highly suggestive of a meniscal source of knee pain and dysfunction. Radiographs and magnetic resonance imaging are frequently utilized to examine for osteoarthritis and to verify the presence of meniscal tears, in addition to ruling out other sources of pain. Non-operative therapy focused on nonsteroidal anti-inflammatory drugs and physical therapy may be able to provide pain relief as well as improve mechanical function of the knee joint. For patients re-fractory to conservative therapy, arthroscopic partial meniscectomy can provide short-term gains regarding pain relief, especially when combined with an effective, regular physiotherapy program. Patients with clear mechanical symptoms and meniscal pathology may benefit from arthroscopic partial meniscectomy, but surgery is not a guaranteed success, especially with concomitant articular pathology. Ultimately, the long-term outcomes of either treatment arm provide similar results for most patients. Further study is needed regarding the short and long-term outcomes regarding conservative and surgical therapy, with a particular focus on the economic impact of treatment as well.展开更多
Autologous fat-derived stromal vascular fraction(SVF) is a mixed cell population that has been used for many years in regenerative plastic surgery.In terms of animal and clinical research,this concise review was perfo...Autologous fat-derived stromal vascular fraction(SVF) is a mixed cell population that has been used for many years in regenerative plastic surgery.In terms of animal and clinical research,this concise review was performed to evaluate the efficacy of SVF in knee degenerative joint disease(KDJD),which could cause pain,disability and severely affect patients’ lives.Thirteen studies retrieved and screened from the databases were included,including six animal studies and seven clinical trials.The metaanalysis of clinical research shows that intra-articular injection of SVF,in combination with adjuvant surgery,could alleviate pain and improve early functional recovery for patients with KDJD at Kellgren-Lawrence(KL) grades Ⅱ–Ⅲ.展开更多
文摘The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. With vascular penetration of less than onethird of the adult meniscus, healing potential in the setting of chronic degeneration remains low. Continued hoop and shear stresses upon the degenerative meniscus results in gross failure, often in the form of complex tears in the posterior horn and midbody. Patient history and physical examination are critical to determine the true source of pain, particularly with the significant incidence of simultaneous articular pathology. Joint line tenderness, a positive Mc Murray test, and mechanical catching or locking can be highly suggestive of a meniscal source of knee pain and dysfunction. Radiographs and magnetic resonance imaging are frequently utilized to examine for osteoarthritis and to verify the presence of meniscal tears, in addition to ruling out other sources of pain. Non-operative therapy focused on nonsteroidal anti-inflammatory drugs and physical therapy may be able to provide pain relief as well as improve mechanical function of the knee joint. For patients re-fractory to conservative therapy, arthroscopic partial meniscectomy can provide short-term gains regarding pain relief, especially when combined with an effective, regular physiotherapy program. Patients with clear mechanical symptoms and meniscal pathology may benefit from arthroscopic partial meniscectomy, but surgery is not a guaranteed success, especially with concomitant articular pathology. Ultimately, the long-term outcomes of either treatment arm provide similar results for most patients. Further study is needed regarding the short and long-term outcomes regarding conservative and surgical therapy, with a particular focus on the economic impact of treatment as well.
基金supported by the National Natural Science Foundation of China (81974347)the National Clinical Research Center for Geriatrics,West China Hospital Sichuan University(Z2021JC002)the “1.3.5 Program for Disciplines of Excellence”,West China Hospital,Sichuan University (ZYJC18002,2018HXFH040)。
文摘Autologous fat-derived stromal vascular fraction(SVF) is a mixed cell population that has been used for many years in regenerative plastic surgery.In terms of animal and clinical research,this concise review was performed to evaluate the efficacy of SVF in knee degenerative joint disease(KDJD),which could cause pain,disability and severely affect patients’ lives.Thirteen studies retrieved and screened from the databases were included,including six animal studies and seven clinical trials.The metaanalysis of clinical research shows that intra-articular injection of SVF,in combination with adjuvant surgery,could alleviate pain and improve early functional recovery for patients with KDJD at Kellgren-Lawrence(KL) grades Ⅱ–Ⅲ.
