Straub T, Hunter R E
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis 55455.
Clin Orthop Relat Res. 1988 Feb;227:238-50.
Sixty-six consecutive patients with acute repair of a complete isolated anterior cruciate ligament (ACL) injury were retrospectively reviewed to evaluate the effectiveness of the authors' surgical technique. All patients noted either a pop, acute swelling, or had acute disability after injury with 58% experiencing all three signs and symptoms. Preoperative testing without anesthesia revealed 95% of patients to have either a positive modified Losee or Lachman test. Postoperative results were obtained by questionnaire in 41 of 42 patients (98%) with a minimum two-year follow-up period. Physical examination was completed in 32 (76%) and arthrometer testing in 30 (71%) patients. Subjective results were good or better in 91%. No patients had buckling or meniscal loss postoperatively. Patellofemoral pain, however, was significant in 15% and severe in 2%. Postoperative functional results were good or better in 78% with all patients participating in sports, 76% in "at risk" sports. A Performance Quotient (P.Q.) was developed to more accurately correlate preinjury and postoperative function. The average P.Q. was 0.87. Objective results were good or better in 100%. Stability was within normal limits by clinical observation in 88%, and by arthrometer testing in 87%. ACL repair is recommended in the young patient who is active in "at risk" sports and who is unwilling to modify activities and willing to undergo a one-year rehabilitation period.
对66例连续进行完全孤立性前交叉韧带(ACL)损伤急性修复的患者进行回顾性研究,以评估作者手术技术的有效性。所有患者在受伤后均出现砰的一声、急性肿胀或急性功能障碍,58%的患者出现了所有这三种体征和症状。术前无麻醉状态下的检查显示,95%的患者改良Losee试验或Lachman试验呈阳性。42例患者中有41例(98%)通过问卷调查获得了术后结果,随访期至少为两年。32例(76%)患者完成了体格检查,30例(71%)患者进行了关节测量仪测试。主观结果显示91%的患者良好或更佳。术后没有患者出现打软腿或半月板损伤。然而,15%的患者出现明显髌股关节疼痛,2%的患者疼痛严重。78%的患者术后功能结果良好或更佳,所有患者都参与了运动,76%的患者参与了“高危”运动。开发了一个表现商数(P.Q.)以更准确地关联伤前和术后功能。平均P.Q.为0.87。客观结果显示100%的患者良好或更佳。通过临床观察,88%的患者稳定性在正常范围内,通过关节测量仪测试,这一比例为87%。对于积极参与“高危”运动、不愿改变活动且愿意接受一年康复期的年轻患者,建议进行ACL修复。