Sherman M F, Warren R F, Marshall J L, Savatsky G J
Medicine Service, Hospital for Special Surgery, New York, NY 10021.
Clin Orthop Relat Res. 1988 Feb;227:229-37.
The progression from chronic anterior cruciate instability to degeneration of the knee has been well documented in animal studies. However, the literature is unclear as to the overall consequences with respect to the development of osteoarthritis. The long-term consequences of the anterior cruciate insufficient knee with or without associated medial collateral ligament insufficiency was investigated in 127 consecutive patients. The effects of meniscal injury and/or meniscectomy in the presence of ligamentous insufficiency was correlated with roentgenographic observations. A scoring system was devised and found to show that anterior cruciate insufficiency naturally progresses toward degenerative osteoarthritis. Meniscectomy with and without an associated medial collateral ligament insufficiency hastens the degenerative process. Progressive functional deterioration was shown to correlate with roentgenographic evidence of degenerative changes. The ultimate success of surgical repairs and reconstructions of the anterior cruciate ligament will not be based only upon functional return to activity or objective stability, but will also depend on the procedure's ability to prevent later development of degenerative osteoarthritis.
在动物研究中，从慢性前交叉韧带不稳定发展到膝关节退变已有充分记录。然而，关于骨关节炎发展的总体后果，文献中尚不清楚。对127例连续患者研究了伴有或不伴有相关内侧副韧带不足的前交叉韧带功能不全膝关节的长期后果。在韧带不足的情况下，半月板损伤和/或半月板切除术的影响与X线观察结果相关。设计了一个评分系统，发现其显示前交叉韧带功能不全自然地向退行性骨关节炎发展。伴有或不伴有相关内侧副韧带不足的半月板切除术会加速退变过程。功能逐渐恶化与退变改变的X线证据相关。前交叉韧带手术修复和重建的最终成功不仅将基于恢复活动的功能或客观稳定性，还将取决于该手术预防后期退行性骨关节炎发展的能力。
