Cohen Moises, Amaro Joicemar Tarouco, Ejnisman Benno, Carvalho Rogério Teixeira, Nakano Kleber Kodi, Peccin Maria Stella, Teixeira Rogério, Laurino Cristiano F S, Abdalla Rene Jorge
Orthopedic Sports Medicine Division, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil.
Arthroscopy. 2007 Jun;23(6):629-34. doi: 10.1016/j.arthro.2007.03.094.
To evaluate the stability and arthrosis of the knee 10 to 15 years after arthroscopic-assisted anterior cruciate ligament (ACL) reconstruction with patellar tendon graft.
From July 1986 to March 1991, 82 patients underwent arthroscopic-assisted ACL reconstruction with patellar tendon graft. Of these, 62 returned for follow-up evaluation between November 2000 and April 2001. Four different physicians, blinded to each other's examination findings, evaluated the radiologic as well as surgical results according to the International Knee Documentation Committee criteria and the Lysholm knee scoring scale.
There were 47 male and 15 female patients. The mean period between injury and surgery was 16 months (range, 2 weeks to 8 years). Results of radiographs were compared with the finding of meniscal lesions during surgery and with International Knee Documentation Committee test results. A statistically significant association (P < .0001) was found between medial or lateral arthrosis of the knee and meniscal injury. In all patients the presence of tears in both menisci was associated with osteoarthrosis in both compartments (medial and lateral).
In patients who underwent arthroscopic-assisted ACL reconstruction with patellar tendon graft who also had medial or lateral meniscectomy (or both), arthrosis of the respective compartments developed by 10 to 15 years after reconstruction. Meniscectomy was also associated with poorer results on objective tests of knee function, even with a stable knee joint.
Level IV, therapeutic case series.
评估采用髌腱移植关节镜辅助下前交叉韧带（ACL）重建术后10至15年膝关节的稳定性及关节病情况。
1986年7月至1991年3月，82例患者接受了髌腱移植关节镜辅助下ACL重建术。其中，62例在2000年11月至2001年4月期间返回进行随访评估。4位互不了解彼此检查结果的医生，根据国际膝关节文献委员会标准和Lysholm膝关节评分量表对影像学及手术结果进行评估。
男性患者47例，女性患者15例。受伤至手术的平均时间为16个月（范围2周至8年）。将X线片结果与手术中半月板损伤情况及国际膝关节文献委员会测试结果进行比较。发现膝关节内侧或外侧关节病与半月板损伤之间存在统计学显著关联（P <.0001）。在所有患者中，双侧半月板撕裂均与双侧间室（内侧和外侧）骨关节炎相关。
在接受髌腱移植关节镜辅助下ACL重建术且同时进行内侧或外侧半月板切除术（或两者）的患者中，重建术后10至15年相应间室出现关节病。半月板切除术还与膝关节功能客观测试结果较差相关，即使膝关节稳定。
IV级，治疗性病例系列。
