膝關節骨科醫學與微創手術

Orthopaedic Science and Minimally Invasive Surgeries of Knee Joints

江鴻生(Hong-Sen Chiang)

《台灣醫學》 19卷1期 (2015/01) Pp. 30-35

https://doi.org/10.6320/FJM.2015.19(1).05

摘要

膝關節是一個活動量和荷重量都很大的主要關節，但是卻欠乏厚實的軟組織保護與同工，因此容易受到傷害、也容易發生退化性病變。不過也就因為膝關節外微軟組織較薄，因此也容易以微創方式進行關節內的各種手術。膝關節如果退化到相當程度，目前已有功能不錯的人工關節可供裝置替換；而且這種替換手術，可以用微創方式以不大的手術切口來進行。但是以人工植入物取代原生組織，畢竟是一個不得已的做法，對膝關節的局部損傷、早期退化，還是要盡一切努力加以整治，以盡量延緩退化的進程。由於關節內視鏡及相關器械的進步發展，這些諸如十字韌帶重建、半月軟骨板修補、軟骨損傷修補等膝關節內部整修手術，也都可以經由微創方式達成。另外，一些新治療選擇，像是玻尿酸和高濃度血小板血漿的關節腔注入，一般相信也能延緩膝關節退化的進程。

關鍵字

膝關節 ； 微創手術

並列摘要

The knee joint bears tremendous weight and has wide range of motion. However, the soft tissue support around this high-loading joint is short. Therefore the knee joint is susceptible to injuries and, as a consequence, easy to degenerate. The lacking of thick soft tissue around the knee joint, however, contributes to the easy accessibility to the joint for intrarticular procedures. Various knee operations are nowadays designed as minimally invasive surgeries (MIS). Advanced degeneration of the knee joint is typically treated with prosthetic replacement arthroplasty, which is achieved by MIS. Nevertheless, such surgery should be considered a salvage procedure and after every attempt to preserve the native joint and slow the progression of degeneration. The utility of arthroscopy and associate instruments have made possible the repair of intrarticular derangements by MIS, such as the reconstruction of cruciate ligaments, repair of meniscal tears, and repair of focal pathology of articular cartilage. New modalities of treatment have also been developed to delay the degeneration, including the intrarticular injection of hyaluronic acid and platelet-rich plasma.

並列關鍵字

knee joint ； minimally invasive surgery

參考文獻

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