Hoy G A, Henderson I J
Mercy Private Hospital, Melbourne, Australia.
J Bone Joint Surg Br. 1994 Jul;76(4):610-3.
We reviewed 32 ankles in 30 patients at an average of five years after a Watson-Jones tenodesis. All but one patient had had ankle pain before operation and 19 had had clicking, catching, or locking of the ankle. Eleven of these had an ankle arthrotomy at the time of ligament reconstruction for intraarticular pathology. At review seven of 23 ankles had a significant decrease in ankle motion, and five in subtalar motion, but only two were unstable on examination. Twenty-one ankles, however, caused some pain on activity and nine were tender on palpation. These findings indicate intra-articular degeneration or injury rather than simple instability. Radiographs of 16 ankles showed good varus and anterior-drawer stability. Seven had talocrural osteoarthritis, but only four showed grade-1 subtalar osteoarthritis. We found no correlation between follow-up time and long-term results. The Watson-Jones tenodesis provides good rotational and lateral ankle instability and does not appear to lead to subtalar degeneration.
我们对30例患者的32个踝关节进行了回顾性研究，这些患者在接受沃森-琼斯肌腱固定术后平均随访了5年。除1例患者外，所有患者术前均有踝关节疼痛，其中19例存在踝关节弹响、卡顿或绞锁。其中11例在韧带重建时因关节内病变进行了踝关节切开术。复查时，23个踝关节中有7个踝关节活动度明显下降，距下关节活动度有5个下降，但检查时只有2个踝关节不稳定。然而，21个踝关节在活动时引起一些疼痛，9个踝关节触诊时有压痛。这些发现提示关节内退变或损伤而非单纯不稳定。16个踝关节的X线片显示内翻和前抽屉试验稳定性良好。7例有胫距骨关节炎，但只有4例显示1级距下骨关节炎。我们发现随访时间与长期结果之间无相关性。沃森-琼斯肌腱固定术可提供良好的旋转和外侧踝关节稳定性，似乎不会导致距下关节退变。
