Robertson G A J, Coleman S G S, Keating J F
The Edinburgh Orthopaedic Trauma Unit, The Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
Knee. 2009 Aug;16(4):245-7. doi: 10.1016/j.knee.2008.12.014. Epub 2009 Jan 31.
We reviewed 100 patients retrospectively following primary ACL reconstruction with quadruple hamstring autografts to evaluate the incidence and factors associated with postoperative stiffness. Stiffness was defined as any loss of motion using the contra-lateral leg as a control. The median delay between injury and operation was 15 months. The incidence of stiffness was 12% at 6 months post-reconstruction. Both incomplete attendance at physiotherapy (p<0.005) and previous knee surgery (p<0.005) were the strongest predictors of the stiffness. Anterior knee pain was also associated with the stiffness (p<0.029). Factors that failed to show a significant association with the stiffness included associated MCL sprain at injury (p=0.32), post-injury stiffness (p=1.00) and concomitant menisectomy at reconstruction (p=0.54). Timing of surgery also did not appear to influence the onset of stiffness (median delays: 29 months for stiff patients; 14 months for non-stiff patients). The rate of stiffness fell to 5% at 12 months postreconstruction, without operative intervention.
我们对100例行四股绳肌自体移植进行初次前交叉韧带重建的患者进行了回顾性研究，以评估术后僵硬的发生率及相关因素。僵硬定义为以对侧腿作为对照，任何活动度的丧失。受伤与手术之间的中位间隔时间为15个月。重建术后6个月时僵硬的发生率为12%。理疗不完整（p<0.005）和既往膝关节手术（p<0.005）都是僵硬的最强预测因素。膝前疼痛也与僵硬相关（p<0.029）。与僵硬未显示出显著相关性的因素包括受伤时合并内侧副韧带扭伤（p=0.32）、伤后僵硬（p=1.00）以及重建时同时行半月板切除术（p=0.54）。手术时机似乎也不影响僵硬的发生（中位间隔时间：僵硬患者为29个月；非僵硬患者为14个月）。重建术后12个月时，未经手术干预，僵硬发生率降至5%。
