Verhelst Pieter-Jan, Luyckx Thomas
Acta Orthop Belg. 2017 Jun;83(2):268-275.
The rupture of the anterior cruciate ligament is one of the most common orthopaedic injuries. This review gives an overview of the surgical treatment of the ACL rupture. A correct knowledge of the anatomy of the ACL is crucial in treating this injury. Recent studies describe the ACl as flat rather than divided in distinct structural bundles. Reconstructive and primary repair techniques can be used to approach this native anatomy. Reconstructive surgery of the ACL still is the golden standard in ACL surgery. An individualized approach is key and should be used. However, ACL reconstruction is not always a success. Return to preinjury of sports only reaches 65% and ACL-reconstructed knees are prone to osteoarthritis. Previous attempts at the primary repair of the ACL were archaic and had disappointing results. Modern diagnostics, operative and biological techniques and strict patient selection could initiate a revival of this technique.
前交叉韧带断裂是最常见的骨科损伤之一。本综述概述了前交叉韧带断裂的手术治疗。正确了解前交叉韧带的解剖结构对于治疗该损伤至关重要。最近的研究将前交叉韧带描述为扁平的，而非分为不同的结构束。重建和一期修复技术可用于恢复其原始解剖结构。前交叉韧带重建手术仍是前交叉韧带手术的金标准。应采用个体化方法，这一点很关键。然而，前交叉韧带重建并不总是成功的。恢复到伤前运动水平的比例仅为65%，且接受前交叉韧带重建的膝关节易患骨关节炎。以往对前交叉韧带进行一期修复的尝试较为陈旧，结果令人失望。现代诊断、手术和生物学技术以及严格的患者选择可能会使该技术复兴。
