儿童及青少年前交叉韧带损伤治疗的研究进展

Advances in the management of anterior cruciate ligament injury in children and adolescents

前交叉韧带(anterior cruciate ligament,ACL)损伤是儿童及青少年群体中一种常见的膝关节损伤。由于骺板尚未闭合,该年龄段患儿ACL损伤的治疗方式一直是医学界面临的难题。临床上,关于此类ACL损伤是否需要手术,存在广泛的争议。随着循证医学的发展,临床治疗策略经历了从过去的保守治疗为主到当前更倾向于重建手术的转变。此外,近年来ACL初次修复技术重新受到关注,并成为除重建手术外的另一种可行选择。本文旨在综述儿童和青少年ACL损伤治疗观点的演变、重建的理念及其方法,以及ACL初次修复术的应用现状,以期为这一临床治疗难题提供科学依据和实践指导。

Anterior cruciate ligament(ACL)injury is a common knee injury in children and adolescents.Due to the open epiphyseal plate,the treatment of ACL injuries in this age group has long been a challenge for the medical community.Clinically,there is widespread controversy regarding whether surgery is necessary for such ACL injuries.With the development of evidence-based medicine,clinical treatment strategies have shifted from conservative treatment in the past to a current preference for reconstructive surgery.In addition,in recent years,ACL primary repair techniques have regained attention and become another viable option besides reconstructive surgery.This article aims to provide a comprehensive review of the evolution of treatment perspectives for ACL injuries in children and adolescents,the concept and methods of reconstruction,and the current status of ACL primary repair techniques,with the hope of providing scientific evidence and practical guidance for this challenging clinical problem.