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摘要

在本研究中,我们对1980-1992年间由同一经验丰富的外科医生手术的105例前交叉韧带断裂患者中的58例进行了临床随访和x线检查。其中大多数是运动事故,尤其是滑雪和足球。在11例患者中发现孤立的前交叉韧带断裂,其余47例患者有其他损伤(主要是内侧副韧带和内侧半月板)。52例行前交叉韧带一期修复术。对于慢性不稳定,4例(7%)患者必须接受继发性前交叉韧带重建。在随访研究中,60%的患者lysholm评分达到95-100分,19%的患者达到84-94分。剩下的21%得分低于84分。在两侧比较中,54例无二次重建的患者中有91%的患者的拉赫曼试验结果相同或显示手术膝关节的稳定性略有下降。90度屈曲膝关节处于中立位时,前路稳定性在相似范围内,前路内侧稳定性稍差。在48%的患者中,我们发现骨关节炎的影像学征象(II期和III期,根据Jäger和Wirth的分类)。
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[The primary cruciate ligament suture--is the method outdated? Results in follow-up of 58 patients].

In the present study 58 out of 105 patients, who had been operated on for anterior cruciate ligament rupture from 1980-1992 by the same experienced surgeon, were followed up clinically and by X-ray examination. Most of them were sports accidents, above all skiing and soccer. In 11 patients an isolated rupture of the anterior cruciate ligament was found, the remaining 47 had sustained additional injuries (mainly the medial collateral ligament and the medial meniscus). In 52 cases the operation was performed with primary repair of the anterior cruciate ligament. For chronic instability 4 patients (7%) had to be treated with secondary anterior cruciate ligament reconstruction. In the follow-up study 60% of all patients achieved a Lysholm-score of 95-100 points, 19% of 84-94 points. The remaining 21% achieved less than 84 points. In the side to side comparison the Lachman Test was equal or showed a slightly diminished stability of the operated knee in 91% of 54 patients without secondary reconstruction. The anterior stability with 90 degrees flexed knee in neutral position was within a similar scope, the anterior medial stability was a little worse. In 48% of all patients we found radiological signs of osteoarthritis (stage II and III according to the classification of Jäger and Wirth).

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