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[组织病理学半月板诊断]

[Histopathological meniscus diagnostic].

作者信息

Fisseler-Eckhoff A, Müller K-M

机构信息

Institut für Pathologie und Zytologie, HSK-Klinik, Ludwig-Erhard-Strasse 100, 65199, Wiesbaden, Deutschland.

出版信息

Orthopade. 2009 Jun;38(6):539-45. doi: 10.1007/s00132-008-1401-7.

Abstract

Menisci fulfill many functions within the complex biomechanics of the knee joint. In the case of meniscus lesions, sparing arthroscopic resections and operative refixation are the treatments of choice. With regard to diagnostics, this means that in general terms, the histopathologic diagnostics are carried out on detached meniscus fragments of between 5 mm and 2 cm in size. An experienced pathologist's knowledge of physiologically possible cellular and fibrous histological meniscus damage, as opposed to nonphysiological change regarded as normal with respect to age, is essential during a diagnostic meniscus evaluation. The clinician expects clear statements from the pathologist regarding the severity of previous or secondary degenerative meniscus damage, the age and type of traumatic tears, and appraisal of the relationship between trauma and meniscus damage from an insurance point of view. Close cooperation between the clinician and the pathologist allows for fast and unambiguous correlation of anamnesis, the clinical picture, and morphological reporting so that cases involving insurance problems - which are numerous, often long-term, and often unsatisfactory - can be clarified quickly.

摘要

半月板在膝关节复杂的生物力学中发挥着多种功能。对于半月板损伤,保留性关节镜下切除术和手术固定是首选治疗方法。在诊断方面,这意味着一般而言,组织病理学诊断是在大小为5毫米至2厘米的分离半月板碎片上进行的。在半月板诊断评估过程中,经验丰富的病理学家了解半月板在生理上可能出现的细胞和纤维组织学损伤,而非将与年龄相关的非生理性变化视为正常情况,这一点至关重要。临床医生期望病理学家能就既往或继发性半月板退行性损伤的严重程度、创伤性撕裂的年龄和类型,以及从保险角度评估创伤与半月板损伤之间的关系给出明确的说明。临床医生与病理学家之间的密切合作能够快速且明确地关联病史、临床表现和形态学报告,从而使涉及保险问题(此类问题众多、往往持续时间长且常常不尽人意)的病例能够迅速得到澄清。

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