Davanzo Diego, Fornaciari Paolo, Barbier Geoffroy, Maniglio Mauro, Petek Daniel
Clinic of Orthopedic Surgery, Kantonsspital Fribourg, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland.
Department of Orthopaedics, Balgrist University Hospital, Forchstrasse 340, 8008 Zürich, Switzerland.
Case Rep Orthop. 2017;2017:1636578. doi: 10.1155/2017/1636578. Epub 2017 May 14.
There is no consensus on the best treatment for anterior cruciate ligament hypoplasia or aplasia. To our knowledge, no comparative study between operative and conservative treatment of this condition has ever been performed. Conservative treatment is a viable alternative to surgery for ACL aplasia. Two siblings were examined at our outpatient clinic. The male patient underwent bilateral ACL reconstruction, while his sister was treated conservatively. Our results show a worse long-term outcome for the operative patient. At her last follow-up, the female patient treated conservatively showed subjective improvement in stability and gait. A review of the literature shows inconsistent outcomes after reconstruction in contrast to reports with cruciate ligament agenesis that did not undergo reconstruction with acceptable to good outcomes. Cruciate reconstruction should be reserved for cases of impaired articular instability, objectively manifest in the frequency of giving-way episodes. Treatment depends on the patient's condition and expectations. Surgery should therefore only be suggested after proper patient counseling.
对于前交叉韧带发育不全或发育不良的最佳治疗方法，目前尚无共识。据我们所知，从未有过针对这种情况进行手术治疗与保守治疗的比较研究。保守治疗是前交叉韧带发育不良手术治疗的一种可行替代方案。我们在门诊对两名兄弟姐妹进行了检查。男性患者接受了双侧前交叉韧带重建，而他的妹妹则接受了保守治疗。我们的结果显示手术患者的长期预后较差。在最后一次随访时，接受保守治疗的女性患者在稳定性和步态方面有主观改善。文献综述表明，与未进行重建但结果可接受或良好的交叉韧带发育不全报告相比，重建后的结果并不一致。交叉韧带重建应仅用于关节不稳定受损的病例，客观表现为打软腿发作的频率。治疗取决于患者的病情和期望。因此，只有在对患者进行适当的咨询后才应建议手术。
