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Abordagem terapêutica das lesões meniscais
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As lesões dos meniscos acometem diversas faixas etárias, desde os mais jovens, até aos mais idosos, podendo ser traumáticas agudas ou associadas a patologia degenerativa. Dada a grande importância biomecânica dos meniscos, a reparação adequada das lesões torna-se imprescindível para evitar complicações degenerativas precoces causadoras de dor crónica e incapacidade funcional.
Com este trabalho pretende-se fazer revisão bibliográfica das abordagens terapêuticas disponíveis para tratamento de lesões meniscais, desde a meniscectomia total e parcial até aos métodos mais recentes de reparação meniscal. Face ao desenvolvimento de novas técnicas e dispositivos cirúrgicos torna-se imperativo avaliar a sua viabilidade e resultados a longo prazo, pelo que, para além da descrição das técnicas, é feita análise dos resultados em diversos estudos e meta-análises. Também são abordados os métodos associados aos avanços de Biologia Molecular, nomeadamente transplante meniscal e utilização de factores de crescimento na reparação meniscal, bem como a reabilitação funcional pós-operatória.
Meniscal injuries can affect individuals of all ages, from the youngest to the eldest. They can be of traumatic origin or associated to degenerative disease. Considering the role of menisci in knee biomechanics, the appropriate repair becomes vital to prevent early joint degeneration with its associated pain and functional impairment. The purpose of this essay is to review the currently available approaches for treatment of meniscal injury, from total and partial meniscectomy to the most recent meniscal repair techniques. Taking into account the development of new surgical techniques and devices it becomes important to evaluate its viability and long term results, and so the description of the techniques and its outcomes from various studies and meta-analyses is provided. With the advance of Molecular Biology, meniscal transplant and use of growth factors for meniscal repair are also taken into consideration. At last, there is a short description of post-operatory rehabilitation tips.
Meniscal injuries can affect individuals of all ages, from the youngest to the eldest. They can be of traumatic origin or associated to degenerative disease. Considering the role of menisci in knee biomechanics, the appropriate repair becomes vital to prevent early joint degeneration with its associated pain and functional impairment. The purpose of this essay is to review the currently available approaches for treatment of meniscal injury, from total and partial meniscectomy to the most recent meniscal repair techniques. Taking into account the development of new surgical techniques and devices it becomes important to evaluate its viability and long term results, and so the description of the techniques and its outcomes from various studies and meta-analyses is provided. With the advance of Molecular Biology, meniscal transplant and use of growth factors for meniscal repair are also taken into consideration. At last, there is a short description of post-operatory rehabilitation tips.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015
Palavras-chave
Meniscos tibiais Ligamento cruzado anterior Ligamento cruzado posterior Osteoartrite