Tierney G S, Wright R W, Smith J P, Fischer D A
Minneapolis Sports Medicine Center, MN 55454, USA.
Am J Sports Med. 1995 Nov-Dec;23(6):755-6. doi: 10.1177/036354659502300620.
During a 27-month period, 222 patients with 227 anterior cruciate ligament-deficient knees underwent arthroscopically assisted reconstructions as outpatient procedures. Bone-tendon-bone autografts were used for 169 of these reconstructions; the other 58 were done with bone-tendon-bone allografts. Additional procedures were performed on 180 of the patients. The interval from injury to reconstruction averaged 29 months. The protocol developed at our clinic employs a general anesthetic administered with the intent of same-day discharge, infiltration of the skin and joint with bupivacaine, a cold compressive dressing, and the use of both ketorolac tromethamine and a Schedule III narcotic (acetaminophen with codeine or with propoxyphene) for postoperative pain control. At an average followup of 10 months, no readmissions in the immediate postoperative period had been required and no short- or long-term postoperative complications could be attributed to the protocol. This safe and effective technique offers the patient the advantage of anterior cruciate ligament reconstruction as a same-day procedure and allows the surgeon to implement its use in any outpatient setting without additional discharge planning.
在27个月的时间里，222例患有227条前交叉韧带损伤膝关节的患者接受了关节镜辅助下的重建手术，作为门诊手术进行。其中169例重建手术采用自体骨-肌腱-骨移植；另外58例采用异体骨-肌腱-骨移植。180例患者还接受了其他手术。从受伤到重建的平均间隔时间为29个月。我们诊所制定的方案采用全身麻醉，目的是当日出院，用布比卡因对皮肤和关节进行浸润麻醉，使用冷压敷料，并使用酮咯酸氨丁三醇和Ⅲ类麻醉药（对乙酰氨基酚与可待因或丙氧芬）来控制术后疼痛。平均随访10个月时，术后近期无需再次入院，且未发现任何短期或长期术后并发症可归因于该方案。这种安全有效的技术为患者提供了将前交叉韧带重建作为当日手术的优势，并允许外科医生在任何门诊环境中实施该手术，而无需额外的出院计划。
