Andersson C, Gillquist J
Department of Orthopaedic Surgery, University Hospital, Linköping, Sweden.
Am J Sports Med. 1992 Jan-Feb;20(1):7-12. doi: 10.1177/036354659202000103.
From a total of 293 patients who had an acute, complete anterior cruciate ligament rupture, we selected all patients (N = 55) who had an anterior cruciate ligament rupture without associated meniscal or ligamentous injuries, and all patients (N = 52) who had an anterior cruciate ligament rupture combined with a rupture, and subsequent primary repair, of the medial collateral ligament. Initially, all patients were assigned to one of two groups: conservative treatment of the anterior cruciate ligament or augmented anterior cruciate ligament repair with the iliotibial band. In the 52 patients who had an anterior cruciate ligament rupture combined with a medial collateral ligament rupture, the associated injuries to the medial collateral ligament and sometimes the posterior oblique ligament, meniscus, and arcuate ligament complex were treated in a similar fashion, without regard to the treatment of the anterior cruciate ligament. Ninety-nine patients (93%) were reexamined 35 to 74 months after the injury, and knee function was evaluated with subjective and objective criteria, including functional tests. Patients who had been treated with augmented anterior cruciate ligament repair had superior stability with better subjective results and returned to strenuous activities more frequently than patients who had undergone conservative treatment. In those patients who had augmented repair, the prognosis did not differ between those who had isolated lesions and those who had combined lesions. Conservative treatment of the anterior cruciate ligament with repair of the medial collateral ligament and other associated injuries, when present, resulted in an almost equally unfavorable outcome for patients with combined and isolated anterior cruciate ligament lesions.
在总共293例急性完全性前交叉韧带断裂患者中，我们选取了所有前交叉韧带断裂但无半月板或韧带损伤的患者（N = 55），以及所有前交叉韧带断裂合并内侧副韧带断裂并随后进行一期修复的患者（N = 52）。最初，所有患者被分为两组：前交叉韧带保守治疗组或采用髂胫束加强前交叉韧带修复组。在52例前交叉韧带断裂合并内侧副韧带断裂的患者中，内侧副韧带以及有时后斜韧带、半月板和弓状韧带复合体的相关损伤均采用类似方法治疗，而不考虑前交叉韧带的治疗方式。99例患者（93%）在受伤后35至74个月接受了复查，并通过主观和客观标准（包括功能测试）对膝关节功能进行了评估。与接受保守治疗的患者相比，采用加强前交叉韧带修复治疗的患者稳定性更好，主观结果更佳，且更频繁地恢复剧烈活动。在接受加强修复的患者中，单纯损伤患者和合并损伤患者的预后无差异。对于合并和单纯前交叉韧带损伤的患者，前交叉韧带保守治疗联合内侧副韧带及其他相关损伤（如有）的修复，其结果几乎同样不理想。
