McCarroll J R, Shelbourne K D, Porter D A, Rettig A C, Murray S
Department of Research and Education, Methodist Sports Medicine Center, Indianapolis, Indiana 46202.
Am J Sports Med. 1994 Jul-Aug;22(4):478-84. doi: 10.1177/036354659402200407.
Between 1976 and 1988 we treated 75 junior high athletes who had midsubstance ruptures of the anterior cruciate ligament and open physes. Thirty-eight children were initially treated conservatively and later had an intraarticular patellar tendon graft reconstruction, 2 patients underwent extraarticular reconstruction and then later had a patellar tendon graft intraarticular reconstruction, and 20 children had a patellar tendon graft reconstruction initially. In all 60 patients the tibial and femoral tunnels were drilled through the open physes. Minimum followup was 2 years (mean, 4.2). Fifty-five of the 60 children were able to return to their original sports; 5 were active in less strenuous sports. No incidence of abnormal growth related to the intraarticular reconstructive surgery was recorded. Three children tore their anterior cruciate ligament grafts more than 2 years after surgery. Our records showed that conservative treatment of the active junior high athlete with an anterior cruciate ligament rupture failed in each case because of recurrent giving way or meniscal tears. Definitive treatment with an intraarticular autogenous patellar tendon graft reconstruction yielded good to excellent results and eliminated subsequent instability episodes and meniscal tears in our study group.
1976年至1988年间，我们治疗了75名患有前交叉韧带中部断裂且骨骺未闭的初中运动员。38名儿童最初接受保守治疗，后来进行了关节内髌腱移植重建；2名患者先进行了关节外重建，后来又进行了髌腱移植关节内重建；20名儿童最初进行了髌腱移植重建。在所有60例患者中，胫骨和股骨隧道均穿过未闭的骨骺进行钻孔。最短随访时间为2年（平均4.2年）。60名儿童中有55名能够恢复到原来的运动项目；5名参与了强度较小的运动。未记录到与关节内重建手术相关的异常生长情况。3名儿童在术后2年多发生了前交叉韧带移植撕裂。我们的记录显示，对于活跃的初中前交叉韧带断裂运动员，保守治疗在每种情况下均告失败，原因是反复出现打软腿或半月板撕裂。在我们的研究组中，采用关节内自体髌腱移植重建进行确定性治疗取得了良好至极佳的效果，并消除了随后的不稳定发作和半月板撕裂。
