双膝前交叉韧带损伤特点及治疗

目的探讨双膝前交叉韧带(ACL)先后断裂的原因及治疗原则。方法1995年1月~2005年8月收治双膝ACL先后损伤患者32例,对双膝致伤因素、先后损伤之间的关系、膝关节不稳的情况进行观察分析,回顾其受伤到手术的时间及治疗情况。结果32例双膝ACL损伤,运动性损伤占78.1%,后一侧ACL损伤的发生与先伤膝关节不稳、病人的年龄、运动程度有关。89.1%的膝关节在ACL损伤后出现不稳。所有患者均在我院接受ACL重建手术,26例患者双膝ACL重建为一次手术完成,6例分次重建。结果提示一侧ACL断裂引起的膝关节不稳可影响到健侧。膝关节ACL断裂后要早期手术重建以恢复膝关节的稳定性,防止继发损伤,降低另一侧膝关节受伤的风险。对于双膝ACL断裂,我们建议一次手术完成双侧重建,以尽早恢复双膝关节稳定性,保证双膝运动功能。

Bilateral Anterior Cruciate Ligament Ruptures

Objective To analyze the mechanism of anterior cruciate ligament (ACL) injury secondary to the previous ACL rupture on the other side and the management principle for bilateral ACL ruptures. Methods Thirty two cases with bilateral ACL ruptures were treated in our institute from Jan. 1995 to Aug. 2005 and were reviewed retrospectively. Results 78.1% of the total cases were injured during participation in sports activities. The second ACL injury was related to the instablility of the primary injured knee, the age of patients and the level of their sports activities. The chief complain of the cases 89.1% was the instability of the knee. All cases were treated with ACL reconstruction. 26 cases of bilateral injuries were surgically managed simultaneously, and the others were treated separately. We recommend that ACL reconstruction should be performed as soon as possible after rupture for preventing from the secondary injury and decreasing the risk of the injury to the other side. In bilateral ACL rupture cases, the reconstruction should be performed simultaneously.