Good L, Odensten M, Gillquist J
Department of Orthopaedic Surgery, University Hospital, Linköping, Sweden.
Am J Sports Med. 1994 Jul-Aug;22(4):518-23. doi: 10.1177/036354659402200414.
Tibial anteroposterior displacement after anterior cruciate ligament reconstruction with a patellar tendon graft was followed prospectively for 2 years in 24 patients with an arthrometer. The femoral ligament insertion location, in a lateral projection, and the change in intraarticular fixation distance, measured with an isometer, were documented intraoperatively. Two years after surgery, the overall mean injured-noninjured difference in anteroposterior displacement was 2.0 +/- 2.3 mm. All grafts were fixed during surgery at 20 degrees of knee flexion. Patients for whom this angle coincided with the angle of minimum intraarticular fixation distance (Group I), and patients who had a femoral ligament insertion location > 2 mm anterior to the center of the normal anterior cruciate ligament attachment (Group A) showed larger tibial displacement than the other patients. An injured-noninjured difference in tibial anteroposterior displacement > or = 3 mm was classified as failure. Groups I and A failure rates were higher than for the other patients. No correlation was found between anteroposterior displacement and magnitude of the change in intraarticular fixation distance. We conclude that anterior femoral locations lead to larger sagittal play after 2 years than central or posterior locations and that the magnitude of the fixation distance is less important than the pattern.
采用髌腱移植重建前交叉韧带后，对24例患者使用关节测量仪进行了为期2年的胫骨前后移位的前瞻性研究。术中记录股骨韧带在侧位片上的插入位置，以及使用等距仪测量的关节内固定距离的变化。术后两年，前后移位的损伤与未损伤侧的总体平均差异为2.0±2.3mm。所有移植物均在膝关节屈曲20度时进行手术固定。该角度与关节内固定距离最小的角度一致的患者（I组），以及股骨韧带插入位置在正常前交叉韧带附着中心前方>2mm的患者（A组），其胫骨移位比其他患者更大。胫骨前后移位的损伤与未损伤侧差异≥3mm被分类为失败。I组和A组的失败率高于其他患者。前后移位与关节内固定距离变化幅度之间未发现相关性。我们得出结论，术后2年，股骨前方位置比中央或后方位置导致更大的矢状面间隙，并且固定距离的大小比模式的重要性更低。
