Shelbourne K D, Porter D A
Methodist Sports Medicine Center, Indianapolis, Indiana.
Am J Sports Med. 1992 May-Jun;20(3):283-6. doi: 10.1177/036354659202000308.
We present the results of a series of patients who had nonoperative management of the medial collateral ligament with anterior cruciate ligament reconstruction. From February 1983 through December 1989, 84 of 90 consecutive patients were available for followup (minimum, 1 year; mean, 3.1 years) with a combined anterior cruciate ligament-medial collateral ligament injury (anterior cruciate ligament rupture and medial collateral ligament tear) received surgical management by the same physician. The last 68 of these 84 patients who met the inclusion criteria underwent patellar tendon graft for anterior cruciate ligament reconstruction, with concomitant nonoperative management of medial collateral ligament tears. Follow-up evaluation consisted of physical examination for medial laxity, range of motion, and isokinetic and KT-1000 testing. Brace use and postoperative level of competition were also recorded. In addition, the patients completed a subjective assessment questionnaire rating pain, swelling, and stability. They also rated overall activity level, and any changes in their ability to do the activities tested: walk, climb stairs, run, jump, or twist. Our results indicate that proper reconstruction of the anterior cruciate ligament, in conjunction with nonoperative management of tears of the medial collateral ligament in combined anterior cruciate ligament-medial collateral ligament injuries, can given excellent stability and good to excellent functional outcome in patients with combined anterior cruciate ligament-medial collateral ligament injuries.
我们展示了一系列内侧副韧带采用非手术治疗并同时进行前交叉韧带重建患者的结果。从1983年2月至1989年12月,90例连续患者中有84例可供随访(最短1年;平均3.1年),这些患者均为前交叉韧带和内侧副韧带联合损伤(前交叉韧带断裂和内侧副韧带撕裂),并由同一位医生进行手术治疗。这84例符合纳入标准的患者中,最后68例采用髌腱移植进行前交叉韧带重建,同时对内侧副韧带撕裂进行非手术治疗。随访评估包括对内侧松弛度、活动范围、等速运动和KT - 1000测试的体格检查。还记录了支具使用情况和术后比赛水平。此外,患者完成了一份主观评估问卷,对疼痛、肿胀和稳定性进行评分。他们还对整体活动水平以及进行测试活动(步行、爬楼梯、跑步、跳跃或扭转)的能力变化进行评分。我们的结果表明,在前交叉韧带和内侧副韧带联合损伤中,正确重建前交叉韧带并结合内侧副韧带撕裂的非手术治疗,可为患者提供出色的稳定性,并带来良好至优异的功能结果。