Graf B K, Lange R H, Fujisaki C K, Landry G L, Saluja R K
Division of Orthopedic Surgery, University of Wisconsin Hospital and Clinics, Madison 53792.
Arthroscopy. 1992;8(2):229-33. doi: 10.1016/0749-8063(92)90041-9.
We evaluated 12 skeletally immature patients with acute, intrasubstance tears of the anterior cruciate ligament (ACL) and open physes for meniscal pathology. Arthrograms were completed in 10 of 12 patients, and subsequent arthroscopy confirmed 8 meniscal tears (4 medial, 4 lateral) in 6 patients. Four patients with repairable menisci underwent arthroscopic meniscal repair and stabilization. Eight patients received quadriceps and hamstrings rehabilitation and returned to sports with a brace. After return to sports, all braced patients developed instability with multiple episodes of "giving way." Average time from initial injury to first episode of instability was 7 months. Seven patients sustained further meniscal damage an average of 15 months (range 7-27 months) after initial injury. We conclude that meniscal pathology is commonly associated with ACL tears in skeletally immature patients and we recommend arthrography or arthroscopy to evaluate patients with suspected ACL tears. Brace management did not prevent instability or new meniscal tears.
我们评估了12例骨骼未成熟的急性前交叉韧带（ACL）实质内撕裂且骨骺开放的患者，以检查半月板病变情况。12例患者中有10例完成了关节造影，随后的关节镜检查证实6例患者存在8处半月板撕裂（4处内侧，4处外侧）。4例半月板可修复的患者接受了关节镜下半月板修复和固定术。8例患者接受了股四头肌和腘绳肌康复治疗，并戴着支具恢复运动。恢复运动后，所有戴支具的患者均出现不稳定，有多次“打软腿”发作。从初次受伤到首次出现不稳定的平均时间为7个月。7例患者在初次受伤后平均15个月（范围7 - 27个月）出现了进一步的半月板损伤。我们得出结论，在骨骼未成熟的患者中，半月板病变通常与ACL撕裂相关，我们建议对疑似ACL撕裂的患者进行关节造影或关节镜检查。支具治疗并不能预防不稳定或新的半月板撕裂。
