Objective To discuss the curative effect of emergency arthroscopic debridement and reduction associated with the second stage anterior cruciate ligament (ACL) reconstruction for acute posterolateral rotatory dislocation of knee. Methods The retrospective study involved 3 patients with acute posterolateral rotarory dislocation treated in Southwest Hospital of Third Military Medical University from September 2007 to August 2008. Emergency arthroscopy was taken to reduce the knee and debride articular cavity. One case with medial collateral ligment (MCL) rupture was repaired and another 2 cases with MCL partialy injury accepted conservative treatment of hinge knee orthosis until natural healing. Three months later, ACL reconstruction with LARS artificial ligament were performed for all patients. The range of motion (ROM) of knee and Lysholm scores were observed during the follow-up. Results The mean duration of follow-up was 15 months. No anterior knee instability had happened. Results of anterior drawer test and talar tilt test were negative, no heteropic ossification was found in 3 patients, the ROM were 0°-130° , 0°-120° and 0°-130° in 3 months after reconstruction surgery, and the Lysholm score were 91 point, 98 point and 94 point in 12 months afier reconstruction. Conclusion Emergency arthroscopic reduction and debridement associated with standard ACL reconstruction results in good curative outcomes for acute posterolateral rotatory dislocation of knee.% 目的总结急诊关节镜下复位清创联合二期韧带重建手术在急性膝关节后外侧旋转脱位治疗中的效果.方法回顾性分析2007年9月至2008年8月第三军医大学西南医院收治的3例急性膝关节后外侧旋转脱位患者的临床资料,3例患者均急诊行关节镜手术清创+复位治疗,其中1例内侧副韧带(MCL)Ⅲ度损伤患者行MCL修补缝合术；2例MCLⅡ度损伤患者佩戴铰链支具保守治疗.术后3个月,3例患者接受LARS人工韧带前交叉韧带(ACL)重建术.观察患者膝关节活动度和Lysholm评分结果.结果平均随访15个月.3例患者均未出现膝关节前向不稳,前抽屉试验、轴移试验阴性；均未发生关节内异位骨化等病变.术后3个月,3例患者的膝关节活动度分别为0°~130°、0°~120°、0°~130°；重建术后12个月,3例患者的Lysholm评分分别为91、88、94分.结论急诊关节镜下复位、关节腔清理术结合标准化的ACL重建术对于膝关节后外侧旋转脱位的治疗效果较好.
展开▼
