膝关节前交叉韧带陈旧性损伤的诊治

Treatment of Old Anterior Cruciate Ligament Injury of Knee Joint

目的探讨及总结陈旧性膝关节前交叉韧带损伤的诊治经验。方法回顾性分析2008年3月至2013年1月我院32例陈旧性膝关节前交叉韧带损伤患者的诊治及随访结果,并以Lysholm评分方法评价诊疗效果。结果 32例陈旧性膝关节前交叉韧带损伤患者经术前、麻醉后再次体检及X线片、MRI检查均得到确诊,经关节镜下重建并处理半月板损伤及软骨缺损等,治疗前平均lysholm评分为(75±2)分,随访1年平均为(95±3)分。结论陈旧性膝关节前交叉韧带损伤较新鲜损伤具有较大诊治难度,根据患者具体情况选择适当治疗方案是治疗的关键。

Objective To investigate the diagnosis and treatment of old anterior crueiate ligament injury. Methods From March 2008 to January. 2013,32 cases of anterior cruciate ligament injury （male 24 cases, female 8 eases, aged froml8 to 38 years with an average of 30 years old）. There were 26 cases of sport injury ,2 cases of low speed traffic accident ,4 case of high speed traffic accident. The time form injury to visit were 3 months to 10 years. All the patients were diagnosis by careful phys- ical examination pre - anesthesia, post - anesthesia and X - ray, MRI examination, anterior cruciate ligament reconstruction and treatment of the complaint such as meniscus and cartilage damage was then carried out under arthroscopy. Results All of the 32 cases of obsolete anterior cruciate ligament injury were diagnosed. After on the average 1 year of follow - up, excellent result were affirmed（ On the average,lysholm score for these cases before treament was 75 ±2 ,the score turned to 95 ± 31 year after operation）. When compared with the fresh anterior cruciate ligament injury, old anterior cruciate ligament injury is more difficult to diagnosis and treat, to treat them with personalized method is necessary.