Allum R L, Jones J R
Injury. 1986 Jul;17(4):256-8. doi: 10.1016/0020-1383(86)90231-7.
Fifty patients presenting themselves with a locked knee were investigated prospectively by examination under anaesthesia and arthroscopy. Definite abnormality was found in 92 per cent. Torn menisci were present in 68 per cent and isolated ruptures of the cruciate ligament in 10 per cent. Loose bodies were found in 3 patients, degenerative changes alone in 2 patients and a pathological medial synovial shelf in 1 patient. No abnormality was demonstrated in 8 per cent. Sixteen per cent of the knees remained locked following the induction of anaesthesia. This study demonstrates that a true mechanical block is not necessarily present and that the position of an unstable meniscal fragment is not consistently related to the fixed position of the knee under anaesthetic. There were no clinical features that allowed the normal knees to be distinguished preoperatively from those with internal derangement. It is proposed that these patients should be managed by prompt examination under anaesthesia, arthroscopy and definitive surgery.
对50例膝关节交锁患者进行了前瞻性研究，通过麻醉下检查和关节镜检查。92%的患者发现明确异常。68%的患者存在半月板撕裂，10%的患者存在交叉韧带孤立性断裂。3例患者发现游离体，2例患者仅有退行性改变，1例患者存在病理性内侧滑膜皱襞。8%的患者未发现异常。16%的膝关节在麻醉诱导后仍处于交锁状态。本研究表明，不一定存在真正的机械性阻塞，不稳定半月板碎片的位置与麻醉下膝关节的固定位置并不总是相关。术前没有临床特征能够将正常膝关节与内部紊乱的膝关节区分开来。建议对这些患者应通过麻醉下快速检查、关节镜检查和确定性手术进行处理。
