Witt A N, Jäger M, Wirth C J
Z Orthop Ihre Grenzgeb. 1979 Apr;117(2):156-63.
Intra- and extra-articular methods of cruciate ligament substitution are available for treating old anteromedial knee-joint instability. Twelve patients with intra-articular cruciate ligament substitution (median third of the patellar ligaments as free transplant) and 24 patients with extra-articular cruicate ligament substitution (operation according to Nciholas) were examined with particular reference to improved stability as follow-up examinations, the results being subjected to comparative evaluation. Intra-artricular cruciate ligament substitution reduces or eliminates the pre-operative instability of the joint which is due to insufficiency of the cruciate liagment, whereas the extra-articular cruciate ligament substitution produces a significantly more frequent reduction of elimination of the instability of the valgus position and of the anteromedial instability. The combination of both methods to remove anteromedial instability of the knee joint may seem a very useful solution of the problem, but it should be limited to a restricted group of patients because it involves also contain disadvantages which make it unsuitable for indiscriminate application.
交叉韧带替代的关节内和关节外方法可用于治疗陈旧性膝关节前内侧不稳定。对12例行关节内交叉韧带替代术（以髌韧带中间三分之一作为游离移植）的患者和24例行关节外交叉韧带替代术（根据尼古拉斯手术方法）的患者进行了检查，特别关注随访检查中稳定性的改善情况，并对结果进行了比较评估。关节内交叉韧带替代可减少或消除因交叉韧带功能不全导致的术前关节不稳定，而关节外交叉韧带替代则更显著地减少或消除外翻位和前内侧不稳定。两种方法联合使用以消除膝关节前内侧不稳定似乎是解决该问题的一个非常有用的办法，但应限于特定的患者群体，因为它也存在一些缺点，不适用于不加选择地应用。
