Besnard P, Goutallier D
Service de Chirurgie Orthopédique et Traumatologique, Hôpital Henri Mondor, Créteil.
Rev Chir Orthop Reparatrice Appar Mot. 1998 Apr;84(2):162-71.
Osteoarthritis in anterior cruciate ligament (A.C.L.) deficient knees is reported by numerous authors, especially when conservatively treated. The aim of this study was to analyze at a longterm follow-up the outcome of these knees after surgical repair of an A.C.L. rupture augmented with carbon fibers.
Forty seven A.C.L. ruptures in 26 men and 21 women, whom mean sport level was low, had a surgical suture augmented with carbon fibers. The clinical and radiological results were analyzed at a mean follow-up of 8 years (6.2 to 10.8 years).
At maximum follow-up, 64 per cent of patients had moderate pain in their operated knee and 11 per cent had major pain. The Lysholm score was 86.5. The "ARPEGE" functional cotation showed only 51 per cent excellent and good results. The mean anterior laxity was 12.8 mm. Sixty eight per cent of operated knees had no pivot shift. Eighteen knees (38 per cent) had femorotibial osteoarthritis and 23 (49 per cent) had femoropatellar osteoarthritis. The frequency and the level of osteoarthritis were correlated with the range of residual anterior laxity.
Low sport level patients with A.C.L. deficient knee may have knee osteoarthritis. An effective correction of the anterior laxity, by any form of surgical treatment, seems indicated in these patients in order to prevent this articular degradation.
众多作者报道了前交叉韧带（A.C.L.）损伤膝关节的骨关节炎，尤其是在保守治疗时。本研究的目的是对这些膝关节在采用碳纤维增强的A.C.L.断裂手术修复后的长期随访结果进行分析。
26名男性和21名女性共47例A.C.L.断裂，其平均运动水平较低，接受了碳纤维增强的手术缝合。在平均8年（6.2至10.8年）的随访中对临床和放射学结果进行分析。
在最长随访时，64%的患者手术膝关节有中度疼痛，11%有重度疼痛。Lysholm评分为86.5。“ARPEGE”功能评分显示仅有51%的结果为优和良。平均前向松弛度为12.8毫米。68%的手术膝关节无轴移。18个膝关节（38%）有股胫关节骨关节炎，23个（49%）有髌股关节骨关节炎。骨关节炎的发生率和程度与残余前向松弛度范围相关。
A.C.L.损伤膝关节且运动水平较低的患者可能会发生膝关节骨关节炎。为防止这种关节退变，对这些患者似乎应采用任何形式的手术治疗有效纠正前向松弛。
