Pressman A E, Letts R M, Jarvis J G
Children's Hospital of Eastern Ontario, Ottawa, Canada.
J Pediatr Orthop. 1997 Jul-Aug;17(4):505-11.
A 12-year retrospective analysis of 42 children with arthroscopically confirmed anterior cruciate ligament disruption was undertaken to determine (a) the subjective efficacy of treatment, (b) the clinical and biomechanical results of operative and nonoperative management, and (c) the most appropriate long-term outcome measurements. Patients were followed up for a mean of 5.3 years from the time of initial treatment and were between the ages of 5 and 17 years (mean, 14.4) at the time of treatment. The children were treated nonoperatively by primary ligament repair or by intraarticular anterior cruciate ligament reconstruction. In the child, a complete tear of the anterior cruciate ligament was best managed by intraarticular surgical reconstruction. This was confirmed by clinical examination (p < 0.01), by a composite knee score involving a clinical examination and patient questionnaire (p < 0.0005), and by testing with the KT-1000 arthrometer. No significant differences in outcome could be attributed to the patient age or the maturity of the growth plates. In the active child, anterior cruciate reconstruction for complete tears resulted in a more stable and functional knee.
对42例经关节镜证实为前交叉韧带断裂的儿童进行了一项为期12年的回顾性分析，以确定：(a)治疗的主观疗效；(b)手术和非手术治疗的临床及生物力学结果；(c)最合适的长期疗效评估指标。患者从初始治疗时起平均随访5.3年，治疗时年龄在5至17岁之间（平均14.4岁）。这些儿童通过初次韧带修复或关节内前交叉韧带重建进行非手术治疗。在儿童中，前交叉韧带完全撕裂最好通过关节内手术重建来处理。这一点通过临床检查得到证实（p<0.01），通过综合膝关节评分（包括临床检查和患者问卷）得到证实（p<0.0005），并通过KT-1000关节测量仪测试得到证实。结果的差异不能归因于患者年龄或生长板的成熟度。在活跃的儿童中，对完全撕裂进行前交叉韧带重建可使膝关节更稳定且功能更好。
