Acute Torn Meniscus Combined With Acute Cruciate Ligament Injury: Second Look Arthroscopy After 3‐Month Conservative Treatment
Acute Torn Meniscus Combined With Acute Cruciate Ligament Injury: Second Look Arthroscopy After 3‐Month Conservative Treatment
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急性半月板撕裂合并急性十字韧带损伤：保守治疗 3 个月后再次进行关节镜检查
DOI：
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发表时间：
1994
影响因子：
4.2
通讯作者：
Akikazu Nakayama
中科院分区：
文献类型：
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作者：
H. Ihara;Megumi Miwa;K. Takayanagi;Akikazu Nakayama
本研究的目的是在关节镜下评估急性半月板撕裂合并急性交叉韧带损伤的自然愈合，这些损伤均采用非手术治疗。32例患者中，30例外侧半月板撕裂和10例内侧半月板撕裂合并急性前交叉韧带损伤25例，后交叉韧带损伤7例。在一些椎间盘上有超过1处撕裂，共计51处撕裂部位。允许半月板和韧带损伤无需手术愈合，但立即给予保护性活动，以刺激损伤胶原纤维的应力导向愈合，并促进滑液循环至半月板和韧带。使用带有螺旋弹簧牵引系统的Kyuro膝关节支具对相关的受伤十字韧带施加适当但不过度的应力。在3个月治疗期前后，对所有膝关节进行检查和关节镜检查。结果显示，69%的外侧髁完全愈合，18%的部分愈合，而58%的内侧髁完全愈合，没有部分愈合。前交叉韧带25例中20例愈合良好，后交叉韧带7例中3例愈合良好。这项研究表明，急性半月板撕裂，即使发生在与交叉韧带损伤，可以愈合形态与非手术治疗。
The purpose of this study was to evaluate arthroscopically the natural healing of an acute torn meniscus combined with an acute cruciate ligament injury treated nonoperatively. There were 30 lateral and 10 medial meniscus tears associated with 25 acute anterior cruciate ligament and 7 posterior cruciate ligament injuries in 32 patients. There was more than 1 tear on some menisci for a total of 51 tear sites. Injuries to the menisci and ligaments were allowed to heal without surgery, but were given protective mobilization immediately in order to stimulate stress oriented healing of injured collagen fibers and promote circulation of synovial fluid to the meniscus and ligament. A Kyuro knee brace with a coil spring traction system was used to add adequate but not excessive stress to the associated injured cruciate ligament. All knees were examined and arthroscoped before and after a 3-month treatment period. Results indicated that 69% of the lateral menisci healed completely and 18% healed partially, whereas 58% of the medial menisci healed completely and none healed partially. Twenty of 25 anterior cruciate ligaments and 3 of 7 posterior cruciate ligaments healed satisfactorily. This study indicated that acute tears of the meniscus, even when they occur in association with a cruciate ligament injury, can heal morphologically with nonsurgical treatment.