Heier K A, Mack D R, Moseley J B, Paine R, Bocell J R
Baylor College of Medicine, Department of Orthopedics, Houston, Texas 77030, USA.
Am J Sports Med. 1997 Jul-Aug;25(4):527-32. doi: 10.1177/036354659702500416.
The purpose of this study was to evaluate the results and complications of anterior cruciate ligament surgery in middle-aged patients. Forty-five consecutive patients over 40 years old (average age, 44.6 years) who had arthroscopically assisted anterior cruciate ligament reconstructions with midthird patellar tendon autografts were evaluated. The patients returned for interviews, physical examinations, radiographs, Biodex dynamometer strength testing, and KT-1000 arthrometer testing at an average of 37 months after their surgeries (range, 24 to 96 months). The mean Lysholm and Gillquist score was 91, which corresponds to symptoms only with vigorous activity. The overall scores from the International Knee Documentation Committee form were 29 (64%) normal or nearly normal and 2 (4%) severely abnormal. Side-to-side differences as determined by the KT-1000 arthrometer were < or = 3 mm in 31 of 40 patients (78%), between 3 and 5 mm in 4 patients (10%), and > 5 mm in 5 patients at 30 pounds of anterior displacement. Seventy-six percent of the patients (N = 34) returned to their preoperative activity levels. Three patients required repeat arthroscopic surgery for persistent knee pain and two patients had graft ruptures. This study shows that when middle-aged patients undergo surgery, their results can be successful and satisfying to a degree similar to those of younger patients.
本研究的目的是评估中年患者前交叉韧带手术的结果及并发症。对45例年龄超过40岁（平均年龄44.6岁）、在关节镜辅助下采用髌腱中1/3自体移植物重建前交叉韧带的患者进行了评估。患者在术后平均37个月（范围24至96个月）返回接受访谈、体格检查、X线片、Biodex测力计力量测试以及KT-1000关节测压计测试。Lysholm和Gillquist平均评分为91分，这仅对应于剧烈活动时出现的症状。国际膝关节文献委员会表格的总体评分中，29例（64%）为正常或接近正常，2例（4%）为严重异常。在30磅前向移位时，40例患者中有31例（78%）经KT-1000关节测压计测定的两侧差异≤3mm，4例（10%）在3至5mm之间，5例＞5mm。76%的患者（N = 34）恢复到术前的活动水平。3例患者因持续性膝关节疼痛需要再次进行关节镜手术，2例患者出现移植物断裂。本研究表明，中年患者接受手术时，其结果在一定程度上可以成功且令人满意，与年轻患者相似。
