前交叉韧带损伤与膝关节骨密度的关系研究

对在我所进行手术的膝关节内损伤３７例进行局部骨密度检测，其中单纯前交叉韧带断裂１０例，前交叉韧带断裂合并内外侧半月板损伤１９例，膝关节内其他损伤但无前交叉韧带损伤的８例。结果显示，全部患者均呈现伤侧骨密度下降，有前交叉韧带断裂的患膝骨密度显著低于膝关节内其他损伤但无前交叉韧带损伤的；前交叉韧带断裂合并半月板损伤的与单纯前交叉韧带断裂相比，骨密度的差异无显著性；前交叉韧带断裂病史在２个月内患膝骨密度显著高于病史长于２个月者。由此建议对前交叉韧带断裂应在伤后２个月内进行修补；此外，当患膝的骨密度低于健侧的７０％时，应在重建前交叉韧带时注意打孔和界面螺丝钉的技术操作，同时适当加强外固定，延长固定时间，以免术后移植骨脱落。

A Clinical Study on the Relationship between Injury of Anterior Cruciate Ligament and Bone Mineral Density of Knee Joint

Bone mineral density (BMD) of knee joints was determined on thirty-seven patients with injuries of knee joints before operation. Among them, 10 had single rupture of anterior cruciate ligament(ACL);19 had rupture of ACL with medial or/and lateral injury of meniscus; 8 had other injuries except ACL rupture. The result showed that all patients had BMD decrease; Bone loss was more severe in patients with ACL deficiency; there was no significant difference of BMD between single ACL rupture and ACL rupture plus injury of meniscus. BMD showed further decrease on patients who had the history of ACL rupture longer than 2 months. Based on these findings, we suggest that for ACL deficiency, reconstruction should be performed within 2 months. Besides, when the BMD is lower than 70% of normal value, the technique of making tunnels and fitting interface screw should be very careful, and the external fixation after operation should be more strengthened and longer than usual as well in order to avoid transplant failure.