Wirth C J, Kohn D
Orthopaedic Hospital, Hannover Medical School, Germany.
Clin Orthop Relat Res. 1996 Apr(325):110-5. doi: 10.1097/00003086-199604000-00012.
From 1976 to 1992, reconstruction after failed anterior cruciate ligament repair or reconstruction was done for 87 patients (8%) compared with 1064 primary operations at the authors' institution. Fifty-seven patients had 1 previous reconstruction, 27 patients had 2, and 3 patients had 3 or more previous reconstructions. Fifty-two patients (60%) were satisfied with their results after a mean followup time of 8 years (range, 2-18 years). Lysholm scores after revisions (68 +/- 12) were significantly inferior compared with scores after primary anterior cruciate ligament surgery (83 +/- 14). The authors favor the use of the patellar tendon or quadriceps tendon autograft in revision surgery. Medial meniscus reconstruction is done whenever possible, or the medial meniscus is replaced by autograft tissue. Open or arthroscopic techniques are used, depending on the individual case.
1976年至1992年期间，在作者所在机构，与1064例初次手术相比，87例患者（8%）因前交叉韧带修复或重建失败后进行了翻修手术。57例患者曾有过1次重建，27例患者有过2次，3例患者有过3次或更多次先前重建。平均随访8年（范围2至18年）后，52例患者（60%）对结果满意。翻修术后的Lysholm评分（68±12）明显低于初次前交叉韧带手术后的评分（83±14）。作者倾向于在翻修手术中使用髌腱或股四头肌肌腱自体移植物。只要有可能，就进行内侧半月板重建，或用自体移植组织替换内侧半月板。根据具体情况采用开放或关节镜技术。
