Küllmer K, Letsch R, Schmit-Neuerburg K P, Turowski B
Abteilung für Unfallchirurgie, Direktor: Prof. Dr. F. Zanella, Universitätsklinikum Essen.
Unfallchirurgie. 1996 Jun;22(3):130-8.
From 87 patients who underwent anterior cruciate ligament (ACL) surgery with an alloplastic ligament (Trevira hochfest) the radiographs of 77 patients were examined by 2 physicians, who were not involved in the operation. They evaluated the increase of degenerative osteoarthritis according to the classification by Holz [12] finding a significant increase of degenerative osteoarthritis after surgery with a mean follow-up of 41.2 months. The ligament reconstruction was performed in 50 fresh ACL tears by reinsertion plus synthetic ligament protection and in 27 chronic instabilities with several failed previous operations by using the alloplastic ligament as an ACL prosthesis by means of a salvage procedure. Both investigators found a significant increase of degenerative osteoarthritis in both groups, but the chronically instable knees had a higher initial value. Patients with concomitant meniscus and/or posterior cruciate ligament (PCL) ruptures showed the highest increase of osteoarthritic changes; isolated ACL tears were found with very low degeneration. Considering the special profile of our collective, the factors that were found to as a risk of osteoarthritis and the comparison with the literature we could not find any indication for a relevantly increased risk of osteoarthritic progression using the Trevira hochfest ligament.
在87例接受同种异体韧带（Trevira hochfest）前交叉韧带（ACL）手术的患者中，2名未参与手术的医生对其中77例患者的X线片进行了检查。他们根据霍尔茨[12]的分类评估退行性骨关节炎的进展情况，发现在平均随访41.2个月后，手术后退行性骨关节炎有显著增加。50例新鲜ACL撕裂患者通过重新植入加合成韧带保护进行韧带重建，27例慢性不稳定且先前多次手术失败的患者通过挽救手术使用同种异体韧带作为ACL假体进行治疗。两位研究者均发现两组患者的退行性骨关节炎均显著增加，但慢性不稳定膝关节的初始值更高。伴有半月板和/或后交叉韧带（PCL）撕裂的患者骨关节炎变化增加最为明显；单纯ACL撕裂患者的退变程度很低。考虑到我们研究群体的特殊情况、发现的作为骨关节炎风险的因素以及与文献的比较，我们未发现使用Trevira hochfest韧带会使骨关节炎进展风险显著增加的任何迹象。
