膝关节镜下同种异体半月板移植术(附2例初步报告)

[目的]通过对2例临床同种异体半月板移植中移植物取材、储存，手术操作技术、术后康复计划和不良反应等方面初步结果的总结，结合相关文献，讨论目前临床异体半月板移植的有关问题，为进一步开展此项临床技术提供参考。[方法]对2例外伤导致严重陈旧性半月板损伤、大部缺失的患者，在关节镜下实施同种异体半月板移植术，拟定术后康复计划，对其症状缓解、关节活动度恢复等近期随访结果作初步报告。[结果]患者无手术副损伤，术后伤口愈合良好，无明显伤口渗液，早期关节肿胀，6周左右肿胀消失。实验室检查未发现免疫排斥反应等征象。疼痛评分术前8分、6分，术后3分、2分。患者膝关节活动度恢复过程顺利。[结论]基于目前对半月板严重损伤者保留和修复半月板治疗中存在的困难，以及半月板属于免疫屏蔽器官的特点，异体半月板移植技术有可能成为治疗半月板严重损伤、缺失的一项重要技术。迄今已有的研究为其提供了充分的理论依据。但目前对其远期效果尚待进一步观察，关于移植物的消毒储存、手术操作技术、功能康复训练等临床问题也有待于进一步研究。

Clinical problems of arthroscopic meniscal allograft(two-cases report and literature review)

[ Objective] To discuss the clinical problems of meniscal transplantation based on 2 cases clinical practical results including the harvest and preserved methods of meniscal allograft, operative procedure, rehabilitation plan and side-effect, combining with literature review, so as to provide reference for further clinical practice and research. [ Method] The meniscal allograft were perfumed with arthroscopic technique on 2 patients, younger than 50 years, suffering from severe meniscus tear or defect at the time of other procedures. The initial clinical results about relieving of symptoms, recovery of functions were evaluated after short time rehabilitations. [ Result] There was no operative side-injury and signs of knee instability. The incisions healed well without exudation. The knee joint swelling disappeared in 6 weeks. Rejection reaction was not observed in all of laboratory tests. The VAS were 8, 6 preoperatively and 3, 2 postoperatively. The processes of rehabilitation were normal. [ Conclusion ] Considering the difficult in maintaining severe tear meniscus and the characteristics of immune evasion of meniscus, meniscal allograft may be expectable option in the future. Very many researches have provided theoretical base. The results of long-time following-up should be further observed and wany clinical problems need to be further solved.