Bowyer G W, Matthews S J
Department of Orthopaedics, Queen Elizabeth Military Hospital, Woolwich, London.
J R Army Med Corps. 1991 Jun;137(2):69-75. doi: 10.1136/jramc-137-02-03.
Twenty two Army patients with synthetic (Gore-tex) anterior cruciate ligament (ACL) reconstructions were reviewed (mean follow up 18 months). Reconstruction appeared to abolish the pivot shift sign in all cases, but some subjective instability persisted in all but 6 patients. Outcome was also assessed by medical (PULHHEEMS) grading: 6 patients were fully fit (graded L2), 7 returned to moderate activity but not full fitness (L3), and 9 remained severely incapacitated (L7 or L8) with 4 of this group being medically discharged. Specific operative complications included: prosthesis breakage (3 partial, 1 complete), infected prosthesis(1), and problems with the tibial screw(3). The range and frequency of complications was similar in other series. Physical fitness is an integral part of a soldier's job, placing particular demands on the knee and on surgical repair of knee injuries. Reports on the Gore-tex ACL prosthesis in other groups have been more encouraging, but there are difficulties in comparing this study with others. ACL insufficiency remains a serious problem, with implications for a soldier's fitness and career. The Gore-tex prosthesis improves stability but does not always allow a soldier to return to full fitness.
对22例接受人工合成（戈尔特斯）前交叉韧带（ACL）重建术的陆军患者进行了回顾性研究（平均随访18个月）。重建术似乎在所有病例中都消除了轴移征，但除6例患者外，其余患者均仍存在一些主观上的不稳定感。还通过医疗（PULHHEEMS）分级对结果进行了评估：6例患者完全康复（L2级），7例恢复到中等活动水平但未完全康复（L3级），9例仍严重丧失能力（L7或L8级），其中4例因病退伍。具体的手术并发症包括：假体断裂（3例部分断裂，1例完全断裂）、假体感染（1例）和胫骨螺钉问题（3例）。其他系列研究中并发症的范围和发生率与此相似。体能是士兵工作的一个组成部分，对膝盖以及膝盖损伤的手术修复有特殊要求。关于其他群体中戈尔特斯ACL假体的报告更令人鼓舞，但将本研究与其他研究进行比较存在困难。ACL功能不全仍然是一个严重问题，对士兵的体能和职业生涯有影响。戈尔特斯假体提高了稳定性，但并不总是能让士兵完全康复。
