Schäfer D, Hintermann B
Orthopädische Universitätsklinik, Kantonspital, Basel.
Sportverletz Sportschaden. 1996 Sep;10(3):63-6. doi: 10.1055/s-2007-993401.
The purpose of this prospective study was the assessment of the chronic unstable ankle joint. With regard to cartilage and ligament lesions this was done arthroscopically. 99 consecutive arthroscopies were performed in patients with symptomatic chronic ankle instability. There were 67 complete ruptures of the anterior talofibular ligament and 45 complete ruptures of the calcaneofibular ligament. A complete rupture of the deltoid ligament was found in 6 cases, always combined with lesions of the lateral ligaments. Cartilage damage of the talus was noted in 51 cases and of the tibial pilon in 12 cases. While all complete lesions of the deltoid ligament were associated with talar cartilage damage, this was different for lateral ligament lesions. 11/22 ruptures of the talofibular ligament were associated with cartilage damage of the talus and 11/22 ruptures presented with an intact talar cartilage. Combined ruptures of the talofibular and the calcaneofibular ligament were associated with talar cartilage damage in 21 cases and presented with intact cartilage in 24 cases. This study demonstrated a near equal distribution of intact and damaged articular cartilage in the presence of lateral ligament lesions indicating that the status of the ligaments allows no conclusion with regard to the cartilage. Arthroscopy therefore can give essential information about the status of the unstable ankle joint concerning operative or conservative treatment.
这项前瞻性研究的目的是评估慢性不稳定踝关节。对于软骨和韧带损伤，采用关节镜检查。对99例有症状的慢性踝关节不稳定患者连续进行了关节镜检查。其中有67例距腓前韧带完全断裂，45例跟腓韧带完全断裂。发现6例三角韧带完全断裂，均合并外侧韧带损伤。51例距骨软骨损伤，12例胫骨平台软骨损伤。虽然所有三角韧带完全损伤均伴有距骨软骨损伤，但外侧韧带损伤情况不同。22例距腓前韧带断裂中有11例伴有距骨软骨损伤，11例距骨软骨完整。距腓前韧带和跟腓韧带联合断裂21例伴有距骨软骨损伤，24例软骨完整。本研究表明，在外侧韧带损伤的情况下，关节软骨完整和损伤的分布几乎相等，这表明韧带状态无法推断软骨情况。因此，关节镜检查可为不稳定踝关节的手术或保守治疗提供关于其状态的重要信息。
