Ihara H, Miwa M, Deya K, Torisu K
Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Kitakyushu, Japan.
J Comput Assist Tomogr. 1996 Mar-Apr;20(2):317-21. doi: 10.1097/00004728-199603000-00029.
The purpose of this study was to evaluate using MRI the natural healing of the anterior cruciate ligament (ACL) when treated conservatively by early protective motion.
Consecutive acute complete intraligamentous ruptures of the ACL in 50 cases that were allowed to heal without surgery were evaluated before and after 3 month treatment by MRI, arthroscopy, and stress radiographs. Twenty-nine of the 50 patients were also reevaluated 11 months from the initial injury, of which 7 were reevaluated again 24 months from the initial injury by MRI. The MR appearance of the treated ACL was categorized into four grades depending on homogeneity, straight band, and size.
MR assessment of the ACL after 3 month treatment demonstrated a well defined normal-sized straight band in 37 cases (74%). There was a significant relationship between the 3 and 11 month MR evaluations (rs = 0.801, p <0.0001). There were also significant relationships between the MR and arthroscopic evaluations (rs = 0.455, p <0.005) and between the MR stress radiographic evaluations (rs = 0.348, p <0.025) after the 3 month treatment.
MRI can demonstrate ACL healing when treated conservatively with early protective mobilization.
本研究旨在通过磁共振成像（MRI）评估前交叉韧带（ACL）在早期保护性运动保守治疗下的自然愈合情况。
对50例连续的急性ACL韧带内完全断裂且未经手术而自愈的病例，在治疗3个月前后分别进行MRI、关节镜检查及应力X线片检查。50例患者中有29例在初次受伤11个月后再次接受评估，其中7例在初次受伤24个月后再次接受MRI评估。根据韧带的均匀性、直带形态及大小，将治疗后的ACL的磁共振表现分为四级。
治疗3个月后对ACL的磁共振评估显示，37例（74%）出现明确的正常大小直带。3个月和11个月时的磁共振评估之间存在显著相关性（rs = 0.801，p <0.0001）。治疗3个月后，磁共振与关节镜评估之间（rs = 0.455，p <0.005）以及磁共振与应力X线片评估之间（rs = 0.348，p <0.025）也存在显著相关性。
当采用早期保护性活动进行保守治疗时，MRI能够显示ACL的愈合情况。
