Butler J C, Andrews J R
Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112.
Clin Orthop Relat Res. 1988 Mar(228):150-2.
Eighty patients presented for evaluation with an acute traumatic hemarthrosis of the knee and negligible instability on clinical examination. All had an examination under general anesthesia followed by arthroscopy. Anatomical lesions were demonstrated in 71 of 80 knees (89%) including anterior cruciate ligament (ACL) disruption in 50 (62%). Twenty-nine of 50 patients (58%) with arthroscopically-demonstrated ACL injuries had associated meniscal tears. Fifteen (19%) demonstrated isolated meniscal tears and nine (11%) osteochondral fractures not detected by conventional roentgenograms. The frequent occurrence of injuries to other joint structures in conjunction with ACL injuries was remarkable. An acute traumatic hemarthrosis of the knee often masks significant lesions. Arthroscopy aids the orthopedic surgeon in determining the full extent of the intraarticular damage.
80例患者因急性创伤性膝关节积血就诊,临床检查时关节不稳可忽略不计。所有患者均在全身麻醉下进行检查,随后接受关节镜检查。80例膝关节中有71例(89%)发现解剖学损伤,其中50例(62%)存在前交叉韧带(ACL)断裂。关节镜证实的50例ACL损伤患者中,29例(58%)伴有半月板撕裂。15例(19%)显示孤立性半月板撕裂,9例(11%)为常规X线片未检测到的骨软骨骨折。ACL损伤常伴有其他关节结构损伤,这一情况很显著。急性创伤性膝关节积血常掩盖严重损伤。关节镜有助于骨科医生确定关节内损伤的全部范围。