骨科英文书籍精读（317）｜膝关节韧带损伤的治疗（5）
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Combined injuries such as anterolateral or anteromedial rotatory instability are the commonest reasons for reconstructive surgery. When the ACL is damaged together with either the medial or lateral collateral ligament, reconstruction of the ACL alone often suffices. The torn ACL is replaced by an autograft (usually from the patellar tendon or from hamstring tendons) or by an allograft. Some surgeons advocate replicating the dual bundle arrangement of the original ligament. The ideal synthetic graft has yet to be developed. Postoperative care will depend on the fixation of the new ligament; in many cases a short period of splintage can be followed by regular physiotherapy to avoid joint stiffness and improve muscle control. Many patients return to sports within 6 months.
The treatment of combined injuries in which the PCL is involved is changing; until recently, it was thought that most of these patients had good function and therefore did not need reconstructive surgery. Newer studies have shown that there is an increased risk of osteoarthritis (especially of the medial compartment) and this is seen as an indication for PCL reconstruction in patients who have more than 10–15 mm of posterior tibial translation in the drawer test. Unlike injuries involving the ACL, combination injuries involving the PCL require all damaged structures to be repaired.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
autograft /'ɔ:təuɡrɑ:ft/自身移植物
allograft /'æloɡræft/同种异体移植物
advocate /ˈædvəkeɪt/v. 提倡，拥护；为……辩护n. 拥护者；辩护者；辩护律师，
replicating the dual bundle arrangement of the original ligament. 复制原韧带的双束排列。
replicate /ˈreplɪkeɪt/vt. 复制；折叠vi. 重复；折转
dual /ˈduːəl/adj. 双的；双重的n. 双数；双数词
synthetic /sɪnˈθetɪk/adj. 综合的；合成的，人造的n. 合成物
Unlike injuries involving the ACL, combination injuries involving the PCL require all damaged structures to be repaired.与ACL损伤不同，PCL的联合损伤需要修复所有损伤的结构。
百度翻译：
合并损伤如前外侧或前内侧旋转不稳是重建手术最常见的原因。当ACL与内侧副韧带或外侧副韧带一起受损时，仅重建ACL就足够了。撕裂的前交叉韧带被自体移植物（通常来自髌腱或腘绳肌腱）或同种异体移植物替代。一些外科医生主张复制原韧带的双束排列。理想的合成接枝物还有待开发。术后的护理将取决于新韧带的固定；在许多情况下，短时间的夹板固定后可以进行常规的物理治疗，以避免关节僵硬和改善肌肉控制。许多病人在6个月内恢复运动。
PCL参与的复合伤的治疗正在改变，直到最近，人们还认为这些患者大部分功能良好，因此不需要进行重建手术。最新的研究表明，骨关节炎（尤其是内侧隔）的风险增加，这被认为是抽屉试验中胫骨后移超过10-15 mm的患者进行PCL重建的一个指标。与涉及ACL的损伤不同，涉及PCL的复合损伤需要修复所有受损结构。