后交叉韧带断裂后继发关节软骨损伤的回顾性研究

目的探讨后交叉韧带断裂后对膝关节软骨及稳定性的影响。方法对2006年5月～2008年5月单纯后交叉韧带断裂患者共79例（79膝），进行了后交叉韧带重建术。骨性关节炎伴后交叉韧带不同程度松弛患者共65例（67膝）。给予非筠体抗炎药、理疗、关节内透明质酸注射，以及口服氨基葡萄糖营养软骨等方法对症治疗。同时对后交叉韧带断裂的79例（79膝）患者（手术组）与关节软骨损伤伴后交叉韧带不同程度松弛的65例（67膝）患者（对照组），进行随访，评估膝关节功能。结果按lysholm评分标准评估。5年后Lysholm评分对照组患者（54．2～59．1）分，平均56．7分；手术组患者（80．5～92．6）分，平均88．7分。手术组有7例患者后抽屉试验为I度松弛，但无膝关节不稳定，余72例后抽屉试验均为阴性。对照组患者均有不同程度松弛、关节失稳。影像资料显示，手术组关节软骨为O例。对照组重度损伤20例。两组比较（P〈0．05）差异有显著性。结论后交叉韧带重建术后可以明显延缓骨性关节炎的发生，并获得良好的临床疗效。

Retrospective study of midterm secondary cartilage injury after posterior cruciate ligament rupture

Objective Explore posterior cruciate ligament rupture after midlongterm effects on knee joint carti lage and stability. Methods In May 2006 May 2008,a total of 79 posterior cruciate ligament rupture （79knee）, conducted a posterior cruciate ligament revascularization. Osteoartheitis with posterior cruciate ligament in patients with different degree of relaxation after a total of 65 cases （67 knee）. Given nonsteroidal antiinflammatory drugs, physical therapy, joint hyaluronic acid injection, and the methods of oral glucosamine cartilage nutrition symptomat ic treatment. At the same time of posterior cruciate ligament rupture after 79 patients （79 knees） （scores） with ar ticular cartilage injury posterior cruciate ligament different degree of relaxation of 65 cases （67 knees） patients （con trol group）. Followup and assessment of knee joint function. Results According to the lysholm criteria assess ment. Five years later Lysholm scale control patients 54.2- 59.1 points, averaging 56.7 points; The surgical pa tients with 80.5-92.6 points, 88.7 points average. There are 7 patients after surgical drawer test for of relaxa tion, but no knee instability; After more than 72 cases of drawer test were negative. Control group patients have dif ferent degree of relaxation, joint instability. Footage showed scores of articular cartilage 0cases. Conser vative groupso 20cases of severe injury. Comparing the two groups （ P 〈0.05） significant difference. Conclusion Posterior cruciate ligament reconstruction after surgery can significantly delay the onset of osteoarthri tis, and obtain good clinical curative effect.