Higgins R W, Steadman J R
Mississippi Sports Medicine and Orthopaedic Center, Jackson.
Am J Sports Med. 1987 Sep-Oct;15(5):439-47. doi: 10.1177/036354658701500503.
From 1979 to 1984, 27 skiers who were either present or past members of the United States Ski Team or professional skiers had 30 ACL tears that were repaired primarily. Only two of the repairs were augmented with autogenous patellar tendon grafts. Five patients had complete knee dislocations, including tears of both cruciate ligaments. Nineteen patients had a concomitant extraarticular iliotibial band tenodesis. Twenty-seven knees (24 patients) were followed an average of 57.6 months postoperatively. Recreational skiing was resumed at 5.4 months on average, and in ski racing and pivot-requiring sports all but three patients resumed participation at an average of 9.1 months. In 78% of the knees there was pain-free function. Mild pain was reported in 19%, the majority of which (4/5) was related to vigorous activity. Of the total, only two knees were reported to have a sensation of giving way. On clinical examination 85% (23/27) had normal pivot shift examination with no evidence of abnormal motion. Four percent (1/27) had a 1+ test and 11% (3/27) had "glides." Arthrometer measurements revealed an average of 7.76 mm anterior displacement with 20 pounds of force on the knee with an ACL repair as compared to 5.56 mm on the uninjured knee. The laxity measurements of knees with repaired ACLs fell within the range reported for uninjured knees in the normal population. Five patients had reinjuries to the ACL at an average time of 28 months postoperatively, with two of five undergoing rerepair. Only one patient had an iliotibial band tenodesis to supplement the original ACL repair.(ABSTRACT TRUNCATED AT 250 WORDS)
1979年至1984年期间,27名曾是或仍是美国滑雪队队员的滑雪者或职业滑雪者发生了30例前交叉韧带(ACL)撕裂,均接受了一期修复。仅2例修复术中使用了自体髌腱移植进行增强。5例患者发生了全膝关节脱位,包括两条交叉韧带均撕裂。19例患者同时进行了关节外髂胫束固定术。对27个膝关节(24例患者)进行了平均57.6个月的术后随访。平均5.4个月后恢复休闲滑雪,除3例患者外,其余患者平均9.1个月后恢复滑雪比赛和需要旋转动作的运动。78%的膝关节功能无痛。19%的患者报告有轻度疼痛,其中大部分(4/5)与剧烈活动有关。总共只有2个膝关节报告有打软腿的感觉。临床检查发现,85%(23/27)的患者旋转推移试验正常,无异常活动迹象。4%(1/27)的患者试验结果为1+,11%(3/27)的患者有“滑动”现象。关节测量仪测量显示,ACL修复术后,膝关节在20磅力作用下平均前向位移7.76 mm,而未受伤膝关节为5.56 mm。ACL修复术后膝关节的松弛度测量值落在正常人群未受伤膝关节报告的范围内。5例患者术后平均28个月ACL再次受伤,其中5例中有2例接受了再次修复。只有1例患者进行了髂胫束固定术以补充最初的ACL修复。(摘要截稿于250字)