Lobenhoffer P, Tscherne H
Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
Orthopade. 1993 Nov;22(6):372-80.
At present there is still a great deal of uncertainty about the natural history of ruptures of the ACL. The literature reveals that a significant number of secondary meniscus lesions and chondral damage results, when a high activity level is maintained. Reconstruction of the ACL now improves objective stability and decreases the meniscectomy rate in a large number of cases. Replacement with a patellar tendon or semitendinosus graft and augmented repair give better results than primary suture of the ligament. A limited arthrotomy or an arthroscopic technique should be used for reconstruction of the ACL. Two tunnel techniques with a lateral incision and single incision techniques with a femoral half tunnel are used. There is no consensus at present on the optimal graft source and surgical technique for ACL reconstruction.
目前,前交叉韧带断裂的自然病程仍存在诸多不确定性。文献表明,若维持较高的活动水平,会导致大量继发的半月板损伤和软骨损伤。如今,前交叉韧带重建可改善客观稳定性,并在大量病例中降低半月板切除术的发生率。采用髌腱或半腱肌移植物进行置换及加强修复,比韧带一期缝合效果更佳。前交叉韧带重建应采用有限切开或关节镜技术。有外侧切口的双隧道技术和带股骨半隧道的单切口技术。目前,对于前交叉韧带重建的最佳移植物来源和手术技术尚无共识。