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首页> 外文期刊>American Journal of Sports Medicine >Clinically assessed knee joint laxity as a predictor for reconstruction after an anterior cruciate ligament injury: a prospective study of 100 patients treated with activity modification and rehabilitation.
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Clinically assessed knee joint laxity as a predictor for reconstruction after an anterior cruciate ligament injury: a prospective study of 100 patients treated with activity modification and rehabilitation.

机译：临床评估的膝关节松弛度可作为前交叉韧带损伤后重建的预测指标：前瞻性研究，对100例接受活动调节和康复治疗的患者进行了研究。

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BACKGROUND: The association of early knee joint laxity with the need for later reconstruction of the anterior cruciate ligament has not been extensively studied. HYPOTHESIS: The grade of knee laxity can be used as an early predictor of the need for later reconstruction. STUDY DESIGN: Cohort study (prognosis); Level of evidence, 2. METHODS: One hundred consecutive patients with an acute arthroscopically verified total anterior cruciate ligament rupture were followed prospectively for 15 years. Lachman and pivot-shift tests were performed with the patient under general anesthesia before arthroscopy. After 3 months, the tests were repeated in an ordinary clinical setting. All patients underwent rehabilitation as the first choice of treatment. Anterior cruciate ligament reconstruction was performed only in cases of significant reinjuries (n = 16) or reparable meniscal lesions (n = 6) at a mean of 4 years after injury (range, 4 months-11 years). After 15 years, 94 patients were available for follow-up. RESULTS: Of the later reconstructed patients (n = 18), 82% had a high-grade Lachman test under anesthesia compared with 63% of the nonreconstructed patients (n = 45; P = .048). At 3 months, 44% of the nonreconstructed patients (n = 32) had a high-grade Lachman test compared with 82% of the reconstructed patients (n = 18; P = .007). Twenty-five patients displayed a normal pivot-shift test at 3 months, of whom 1 underwent later reconstruction (P = .009). A high-grade pivot-shift test at 3 months was associated with an 11.4 relative risk for reconstruction. CONCLUSION: A positive pivot-shift test at 3 months after injury in an awake patient is the strongest predictor for the future need for reconstruction. Furthermore, a normal pivot-shift test at 3 months indicates a low risk for reconstruction and is characteristic for copers.
机译：背景：早期膝关节松弛与以后需要重建前交叉韧带之间的关系尚未得到广泛研究。假设：膝关节松弛程度可作为早期预测是否需要后期重建。研究设计：队列研究（预后）;证据级别：2。方法：连续随访了一百例经关节镜检查证实的前交叉韧带全破裂的急性患者，持续15年。关节镜检查前在全身麻醉下对患者进行Lachman和枢轴移位测试。 3个月后，在普通临床环境中重复测试。所有患者均接受康复治疗作为首选治疗方法。仅在受伤后平均4年（范围为4个月至11年）的平均再伤（n = 16）或可修复的半月板病变（n = 6）的情况下进行前交叉韧带重建。 15年后，有94名患者可供随访。结果：在后来的重建患者（n = 18）中，有82％的患者在麻醉下进行了高级Lachman检验，而未重建的患者中有63％（n = 45; P = .048）。在3个月时，有44％的未重建患者（n = 32）接受了高级Lachman检验，而82％的重建患者（n = 18; P = .007）。 25例患者在3个月时表现出正常的枢轴移位测试，其中1例接受了以后的重建（P = .009）。在3个月时进行的高级枢轴移位测试与11.4相对重建风险相关。结论：清醒患者受伤后3个月的阳性枢轴移位测试是未来重建需求的最强预测指标。此外，在3个月时进行正常的轴心位移测试表明重建风险低，并且是铜牙病的特征。

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