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中华关节外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (03) : 415 -423. doi: 10.3877/cma.j.issn.1674-134X.2023.03.018

综述

前交叉韧带损伤及重建后继发性膝骨关节炎的研究进展
赵宇, 赵松, 赵金忠†()   
  1. 215163　苏州，南京大学医学院附属苏州医院骨科
    200233　上海交通大学附属第六人民医院运动医学科
  • 收稿日期:2022-02-12 出版日期:2023-06-01
  • 通信作者: 赵金忠
  • 基金资助:
    国家重点研发计划项目(2018YFC1106200); 上海市浦江人才计划(2020PJD041); 苏州高新区青年科技项目(2019Q014)

Research progress in secondary knee osteoarthritis after anterior cruciate ligament injury and reconstruction

Yu Zhao, Song Zhao, Jinzhong Zhao†()   

  1. Department of Orthopedics, the Affiliated Suzhou Hospital of Medical School, Nanjing University, Suzhou 215163, China
    Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
  • Received:2022-02-12 Published:2023-06-01
  • Corresponding author: Jinzhong Zhao
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赵宇, 赵松, 赵金忠. 前交叉韧带损伤及重建后继发性膝骨关节炎的研究进展[J]. 中华关节外科杂志(电子版), 2023, 17(03): 415-423.

Yu Zhao, Song Zhao, Jinzhong Zhao. Research progress in secondary knee osteoarthritis after anterior cruciate ligament injury and reconstruction[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(03): 415-423.

前交叉韧带(ACL)断裂是常见的膝关节运动损伤，篮球、足球等接触性运动的运动员ACL损伤的年发病率为0.15%~3.7%，其损伤后对膝关节的稳定性影响巨大。对于ACL损伤的治疗方案仍存在争议，目前主要的治疗方式为手术治疗和保守治疗，虽然手术重建韧带可以部分恢复膝关节的稳定性，但从长期随访结果来看，ACL重建手术未能有效降低膝关节创伤后骨关节炎(PTOA)的发病率。本文旨在通过文献检索，对膝关节PTOA的发病机制、保守治疗与手术治疗，以及不同手术方式(单束、双束及前外侧结构重建等)对膝关节PTOA的影响进行综述，以期针对ACL损伤后的治疗为临床医生提供参考，尽可能降低ACL损伤后骨关节炎的发生率。

关键词: 膝关节, 前交叉韧带重建, 创伤和损伤

Anterior cruciate ligament(ACL) rupture is a common sports injury of the knee joint. The incidence rate of ACL injuries in basketball, football and other contact sports athletes is 0.15% to 3.7%, which has a great influence on the stability of the knee joint after injury. The treatment plan for anterior cruciate ligament injury is still controversial. The main treatment is surgical treatment and conservative treatment. Although reconstruction of ligament can partially restore the stability of the knee joint, but from the long-term follow-up results, ACL reconstruction surgery can’t effectively reduce the incidence rate of post-traumatic osteoarthritis (PTOA) of the knee. Through literature search, this paper aimed to explore the pathogenesis, conservative treatment and surgical treatment of knee PTOA, and the effects of different surgical methods (single bundle, double bundle and anterolateral structural reconstruction) on knee PTOA, in order to provide reference for clinicians on the treatment after ACL injury and reduce the incidence of osteoarthritis after ACL injury as much as possible.

Key words: Knee joint, Anterior cruciate ligament reconstruction, Wounds and injuries
图1 ACL(前交叉韧带)损伤后PTOA(创伤后骨关节炎)可能的发病机制注：↑－增加；↓－减少
Figure 1 The pathogenesis of post-traumatic osteoarthritis following ACL injuries
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