Buss D D, Min R, Skyhar M, Galinat B, Warren R F, Wickiewicz T L
Hospital for Special Surgery, New York, New York, USA.
Am J Sports Med. 1995 Mar-Apr;23(2):160-5. doi: 10.1177/036354659502300206.
Conservative treatment of acute anterior cruciate ligament injuries was recommended to selected patients, including those with sedentary occupations, low athletic demands, or ages greater than 30 years. Patients with generalized hyperligamentous laxity were excluded. Fifty-five of 61 patients were available at an average followup of 46 months from the time of initial injury. At followup, giving-way symptoms had not occurred in 23 patients (42%); in 22 (40%) giving way occurred occasionally. Of the 44 patients involved in high- or moderate-demand athletics, 33 (70%) were able to continue with moderate-demand sports. Presence of a medial collateral ligament sprain did not affect the longterm function. Forty-eight percent of the patients scored excellent or good (9 and 18 patients, respectively) on the Hospital for Special Surgery ligament scoring system; 8 (15%) later chose surgical reconstruction. The remaining 47 patients did not believe that their symptoms were severe enough to warrant any further intervention. In a group of individuals who are older and relatively inactive, nonoperative management of anterior cruciate ligament injuries can yield satisfactory results, provided the patients are willing to accept a modest amount of instability and a slight risk of meniscal injury.
对于部分患者，建议采用保守治疗急性前交叉韧带损伤，这些患者包括从事久坐职业、运动需求低或年龄大于30岁的人群。全身韧带松弛的患者被排除在外。61例患者中有55例在初次受伤后平均随访46个月时可获得随访结果。随访时，23例患者（42%）未出现打软腿症状；22例患者（40%）偶尔出现打软腿。在44例参与高需求或中等需求运动的患者中，33例（70%）能够继续进行中等需求的运动。内侧副韧带扭伤的存在并不影响长期功能。在特种外科医院韧带评分系统中，48%的患者评分优秀或良好（分别为9例和18例）；8例（15%）后来选择了手术重建。其余47例患者认为他们的症状不够严重，无需进一步干预。在一组年龄较大且相对不活跃的个体中，前交叉韧带损伤的非手术治疗可以产生令人满意的结果，前提是患者愿意接受一定程度的不稳定和轻微的半月板损伤风险。
