Bräm J, Plaschy S, Lütolf M, Leutenegger A
Chirurgische Klinik und Röntgeninstitut des Rätischen Kantons-und Regionalspitals Chur.
Z Unfallchir Versicherungsmed. 1994 Jul;87(2):91-109.
In the present study 58 out of 105 patients, who had been operated on for anterior cruciate ligament rupture from 1980-1992 by the same experienced surgeon, were followed up clinically and by X-ray examination. Most of them were sports accidents, above all skiing and soccer. In 11 patients an isolated rupture of the anterior cruciate ligament was found, the remaining 47 had sustained additional injuries (mainly the medial collateral ligament and the medial meniscus). In 52 cases the operation was performed with primary repair of the anterior cruciate ligament. For chronic instability 4 patients (7%) had to be treated with secondary anterior cruciate ligament reconstruction. In the follow-up study 60% of all patients achieved a Lysholm-score of 95-100 points, 19% of 84-94 points. The remaining 21% achieved less than 84 points. In the side to side comparison the Lachman Test was equal or showed a slightly diminished stability of the operated knee in 91% of 54 patients without secondary reconstruction. The anterior stability with 90 degrees flexed knee in neutral position was within a similar scope, the anterior medial stability was a little worse. In 48% of all patients we found radiological signs of osteoarthritis (stage II and III according to the classification of Jäger and Wirth).
在本研究中，对1980年至1992年间由同一位经验丰富的外科医生进行前交叉韧带断裂手术的105例患者中的58例进行了临床随访和X线检查。其中大多数为运动损伤，尤其是滑雪和足球运动损伤。11例患者被发现为单纯前交叉韧带断裂，其余47例还伴有其他损伤（主要是内侧副韧带和内侧半月板损伤）。52例患者接受了前交叉韧带一期修复手术。对于慢性不稳定患者，4例（7%）不得不接受二期前交叉韧带重建治疗。在随访研究中，所有患者中有60%的Lysholm评分为95 - 100分，19%为84 - 94分。其余21%的患者评分低于84分。在双侧对比中，54例未进行二期重建的患者中有91%的患者Lachman试验显示手术侧膝关节稳定性相同或略有下降。膝关节在中立位90度屈曲时的前向稳定性在类似范围内，前内侧稳定性稍差。在所有患者中有48%发现了骨关节炎的放射学征象（根据耶格尔和维尔特的分类为II期和III期）。
