前交叉韧带损伤
前交叉韧带损伤患者指南
概述
The anterior cruciate ligament (ACL) is probably the most commonly injured ligament of the knee. In most cases, the ligament is injured by people participating in athletic activity. As sports have become an increasingly important part of day-to-day life over the past few decades, the number of ACL injuries has steadily increased. This injury has received a great deal of attention from orthopedic surgeons over the past 15 years, and very successful operations to reconstruct the torn ACL have been invented.
前交叉韧带（ACL）可能是膝盖最常见的损伤韧带。在大多数情况下，韧带损伤发生于参加田径运动的人员。随着体育运动成为日常生活中日益重要的一部分，发生ACL损伤的病人数逐步增加。在过去15年中，矫形外科医生对这种损伤非常重视，并且开创了对撕裂的ACL进行重建的非常成功的手术。
This guide will help you understand
· where in the knee the ACL is located
· how an ACL injury causes problems
· how doctors treat the condition
本指南帮助你理解:
ACL位于膝盖哪个位置
ACL损伤会引起什么问题
医生如何进行治疗
解剖
Where is the ACL, and what does it do?
ACL的位置及作用？
Ligaments are tough bands of tissue that connect the ends of bones together. The ACL is located in the center of the knee joint where it runs from the backside of the femur (thighbone) to connect to the front of the tibia (shinbone).
韧带是将骨骼的两端连接在一起的坚韧的组织束带。ACL位于膝关节的中间，从股骨（大腿骨）的后部延伸，连接到胫骨（小腿骨）的前部。
The ACL runs through a special notch in the femur called the intercondylar notch and attaches to a special area of the tibia called the tibial spine.
ACL行经股骨远端一个特别的凹槽，称为髁间窝，并附着在胫骨近端的一个特殊区域，称为胫骨棘。
The ACL is the main controller of how far forward the tibia moves under the femur. This is called anterior translation of the tibia. If the tibia moves too far, the ACL can rupture. The ACL is also the first ligament that becomes tight when the knee is straightened. If the knee is forced past this point, or hyperextended, the ACL can also be torn.
ACL主要限制胫骨在股骨下方向前移动。即胫骨前移。如果胫骨前移太远，ACL可能会断裂。ACL也是膝关节伸直时首先拉紧的一条韧带。如果膝关节伸直超过极限，即过伸，ACL也可能被撕裂。
Other parts of the knee may be injured when the knee is twisted violently, as in a clipping injury in football. It is not uncommon to also see a tear of the medialcollateral ligament (MCL) on the inside edge of the knee, and the lateral meniscus, which is the U-shaped cushion between the outer half of the tibia and femur bones.
当膝关节剧烈扭转时，膝盖的其他部位也会受伤，例如在踢足球时撞击受伤。伴有内侧副韧带（在膝关节的内侧边缘）和外侧半月板(胫骨的外半部和股骨之间的U形垫裂片）撕裂并不罕见。
Related Document: A Patient’s Guide to Knee Anatomy
相关文章：英汉对照骨科患者指南045：膝关节解剖
中英文字幕：膝关节解剖（Anatomy of the Knee）
原因
How do ACL injuries occur?
ACL损伤怎样发生的？
The mechanism of injury for many ACL ruptures is a sudden deceleration(slowing down or stop), hyperextension, or pivoting in place. Sports-related injuries are the most common.
许多ACL损伤的损伤机制是突然减速（减速或停止），过度伸展或原地旋转。最常见的是体育运动相关的伤害。
The types of sports that have been associated with ACL tears are numerous. Those sports requiring the foot to be planted and the body to change direction rapidly (such as basketball) carry a high incidence of injury. In this way, most ACL injuries are considered noncontact. However, contact-related injuries can result in ACL tears. For example, a blow to the outside of the knee when the foot is planted is the most likely contact-related injury.
与ACL撕裂相关的运动类型很多。那些需要脚固定在地而身体快速改变方向（如篮球运动）的运动，发生这种伤害机率较高。如此，大多数ACL损伤被认为是非接触性损伤。然而，接触相关的伤害也会导致ACL撕裂。例如，当脚站在地上时，对膝关节外部的撞击是最可能的接触相关性损伤。
Football is also frequently the source of an ACL tear. Football combines the activity of planting the foot and rapidly changing direction and the threat of bodily contact. Downhill skiing is another frequent source of injury, especially since the introduction of ski boots that come higher up the calf. These boots move the impact of a fall to the knee rather than the ankle or lower leg. An ACL injury usually occurs when the knee is forcefully twisted or hyperextended while the foot remains in contact with the ground. Many patients recall hearing a loud pop when the ligament is torn, and they feel the knee give way.
足球运动也常常是ACL撕裂的损伤原因。足球运动时包含了脚站在地上而快速改变方向和身体接触的威胁。高山滑雪是另一个常见的损伤原因，特别是发明高于小腿的滑雪靴以后。这类靴子将跌倒的伤害从踝关节或小腿转移到膝关节。当脚保持与地面接触时，膝关节强力扭曲或过度伸展时，通常会发生ACL损伤。当韧带撕裂时，许多患者会回忆起有一个响声，并感觉到膝关节失去控制。
The number of women suffering ACL tears has dramatically increased. This is due in part to the rise in women’s athletics. But studies have shown that female athletes are two to four times more likely to suffer ACL tears than male athletes in the same sports.
发生ACL撕裂的女性人数有显著增加，这是由于女子参加田径运动人数的增加。但是研究表明，在同一类运动中，女运动员发生ACL撕裂是男运动员的2~4倍。
Recent research has shown several factors that contribute to women’s higher risk of ACL tears. Women athletes seem less able to tighten their thigh muscles to the same degree as men. This means women don’t get their knees to hold as steady, which may give them less knee protection during heavy physical activity. Also, tests show that women’s quadriceps and hamstring muscles work differently than men’s. Women’s quadriceps muscles (on the front of the thigh) work extra hard during knee-bending activities. This pulls the tibia forward, placing the ACL at risk for a tear.
最近的研究显示出几个因素导致女性ACL撕裂的风险较高。女运动员大腿肌肉看似不如男的那样收紧。这意味着女的不能与男的一样保持膝关节的稳定，这可能会在身体活动过程中削弱对膝关节的保护。此外，测量显示，女性的股四头肌和腘绳肌与男性的作用不同。在膝关节屈曲活动期间，女性的股四头肌（在大腿前方）的更用力，这样会将胫骨拉向前方，使得ACL有撕裂的风险。
Meanwhile, women’s hamstring muscles (on the back of the thigh) respond more slowly than in men. The hamstring muscles normally protect the tibia from sliding too far forward. Women’s sluggish hamstring response may allow the tibia to slip forward, straining the ACL. Other studies suggest that women’s ACLs may be weakened by the effects of the female hormone estrogen. Taken together, these factors may explain why female athletes have a higher risk of ACL tears.
同时，女性腘绳肌（在大腿后方）的反应比男性慢。通常，腘绳肌防止胫骨向前滑动太远。女性迟钝的腘绳肌反应可能使胫骨向前滑动，使ACL拉伤。其他研究表明，女性雌激素的作用可能会削弱ACL。总而言之，这些因素可解释为什么女运动员ACL撕裂风险较高。
症状
What does a torn ACL feel like?
ACL撕裂会有什么样的感觉？
The symptoms following a tear of the ACL can vary. Some patients report hearing and/or feeling a pop. Usually, the knee joint swells within a short time following the injury. This is due to bleeding into the knee joint from torn blood vessels in the damaged ligament. The instability caused by the torn ligament leads to a feeling of insecurity and giving way of the knee, especially when trying to change direction on the knee. The knee may feel like it wants to slip backwards. There may be activity-related pain and/or swelling. Walking downhill or on ice is especially difficult. And you may have trouble coming to a quick stop.
ACL撕裂后的症状各有不同。有些患者报告听到和/或感到响声。通常，膝关节在受伤后的短时间内开始肿胀。这是由于血液从损伤的韧带中断裂的血管中渗入膝关节。由于韧带撕裂导致的不稳使患者感到膝关节不安全和无力，特别是在试图改变膝关节方向时。患者可能会感觉膝关节像要向后滑。活动时可能出现疼痛和/或肿胀。走下坡或在冰上行走特别困难。患者前进时可能难以快速停下。
The pain and swelling from the initial injury will usually be gone after two to four weeks, but the knee may still feel unstable. The symptom of instability and the inability to trust the knee for support are what require treatment. Also important in the decision about treatment is the growing realization by orthopedic surgeons that long-term instability leads to early arthritis of the knee.
最初损伤的疼痛和肿胀通常在２～４周后消失，但膝关节仍可能感觉不稳定。不稳定和没信心支撑膝关节等症状是需要治疗的。矫形外科医生越来越多地认识到长期不稳定性会导致膝关节早期发生关节炎，这也是决定治疗方案的重要因素。
Related Document: A Patient’s Guide to Osteoarthritis of the Knee
中英文字幕：膝关节骨关节炎（Osteoarthritis of the Knee）
诊断
How do doctors identify ACL injuries?
医生如何确诊ACL损伤？
The history and physical examination are probably the most important ways to diagnose a ruptured or deficient ACL. In the acute (sudden) injury, the swelling is a good indicator. A good rule of thumb that orthopedic surgeons use is that any tense swelling that occurs within two hours of a knee injury usually represents blood in the joint, or a hemarthrosis. If the swelling occurs the next day, the fluid is probably from the inflammatory response.
病史和体格检查可能是诊断ACL断裂和欠缺的最重要方法。在急性（突然发生的）损伤中，肿胀是一个很有用的征象。矫形外科医生使用的一个很有用的经验是在膝关节损伤的两个小时内发生的任何紧张肿胀通常表明关节内有血（即关节积血）。如果肿胀发生在第二天，则液体可能来自炎症反应。
Placing a needle in the swollen joint and aspirating (or draining as much fluid as possible) gives relief from the swelling and provides useful information to your doctor. If blood is found when draining the knee, there is about a 70 percent chance it represents a torn ACL. This fluid can also show if the cartilage on the surface of the knee joint was injured.
将针插入肿胀的关节中并抽吸（即引流出尽可能多的液体）可以缓解肿胀，并为您的医生提供有用的信息。如果在膝关节引流时发现血液，那么有70％的概率代表ACL撕裂。如果膝关节表面的软骨受伤，这种液体也可以显示出来。
During the physical examination, special stress tests are performed on the knee. Three of the most commonly used tests are the Lachman test, the pivot-shift test, and the anterior drawer test. The doctor will place your knee and leg in various positions and then apply a load or force to the joint. Any excess motion or unexpected movement of the tibia relative to the femur may be a sign of ligament damage and insufficiency.
在体格检查中，对膝关节进行特殊的压力试验。三个最常用的测试是拉赫曼试验，轴移试验和前抽屉试验。医生将您的膝关节和腿部放置在各种位置，然后对关节施加负荷或压力。胫骨相对于股骨的任何过度活动或意想不到的移动可能是韧带损伤和功能不良的征兆。
Another way to check for anterior tibial translation is with the KT-1000 and KT-2000 arthrometers. The patient’s leg is bent and supported on a wedge with the knee in 30 degrees of flexion. The arthrometer is placed against the knee to be tested and strapped to the lower leg. Usually, the normal knee is tested first. The arthrometer applies an anterior force of 15 pounds against the tibia. The amount of anterior tibial translation is measured. The test is repeated with a force of 20 pounds. A third test applies a manual maximal force to the posterior (back) of the tibia. This is similar to the Lachman test.
检查前胫骨前移的另一种方法是使用KT-1000和KT-2000关节测量仪。患者的腿弯曲用楔形物支撑，膝关节屈曲30度。将该测量仪放置在膝关节上以进行测试并固定到小腿上。通常，首先测试健侧膝关节。测量仪对胫骨施加15磅的向前力量。测量胫骨向前平移量。用20磅的力量重复测试。第三个测试将手动最大力量作用于胫骨后部（背部）。这与拉赫曼试验类似。
The results of these tests will help your doctor determine how badly the ACL was injured. Other tests may be combined with tests of ACL integrity to determine whether other knee ligaments, joint capsule, or joint cartilage have also been injured.
这些测试的结果将帮助您的医生确定ACL受损的严重程度。其他测试可以与ACL完整性测试结合，以确定其他膝关节韧带，关节囊或关节软骨是否也受伤。
Your doctor may order X-rays of the knee to rule out a fracture. Ligaments and tendons do not show up on X-rays, but bleeding into the joint can result from a fracture of the knee joint, or when portions of the joint surface are chipped off. Magnetic resonance imaging (MRI) is probably the most accurate test for diagnosing a torn ACL without actually looking into the knee. The MRI machine uses magnetic waves rather than X-rays to show the soft tissues of the body. This machine creates pictures that look like slices of the knee. The pictures show the anatomy, and any injuries, very clearly. This test does not require any needles or special dye and is painless.
你的医生可以运用膝关节的X射线来排除骨折。韧带和肌腱在X射线上不能显示，但是关节内的渗出可能是由于膝关节的骨折，或者当关节表面部分剥落时引起的。磁共振成像（MRI）可能是诊断ACL撕裂的最准确的检查，而无需真正进入到关节内去看一看。MRI机器使用磁场而不是X射线来显示身体的软组织。这种机器创建的照片看起来像膝关节切开的图像，这种照片能够非常清楚地显示解剖结构及一些伤害。该检查不需要任何穿刺或特殊造影剂，而且是无痛的。
In some cases, arthroscopy may be used to make the definitive diagnosis if there is a question about what is causing your knee problem.
在某些情况下，如果对关于什么原因导致膝关节问题有疑问，关节镜检查可用于作出明确的诊断。
Arthroscopy is an operation that involves inserting a small fiber-optic TV camera into the knee joint, allowing the orthopedic surgeon to look at the structures inside the joint directly. The vast majority of ACL tears are diagnosed without resorting to this type of surgery, though arthroscopy is sometimes used to repair a torn ACL.
关节镜检查是一项涉及将小型光纤电视摄像机插入膝关节的操作，可让矫形外科医生直接观察关节内的结构。绝大多数ACL撕裂的诊断一般不采取这种类型的手术，尽管关节镜有时用于修复撕裂的ACL。
治疗
How do doctors treat an ACL injury?
医生如何治疗ACL损伤？
非手术治疗
Initial treatment for an ACL injury focuses on decreasing pain and swelling in the knee. Rest and mild pain medications, such as acetaminophen (Tylenol®), can help decrease these symptoms. You may need to use crutches until you can walk without a limp. Most patients are instructed to put a normal amount of weight down while walking. The knee joint may need to be drained with a needle (mentioned earlier) to remove any blood in the joint.
ACL损伤最初治疗着眼于减轻膝关节疼痛和肿胀。休息和缓解疼痛的药物，如对乙酰氨基酚（Tylenol®）可以帮助减轻这些症状。您可能需要使用拐杖，直到您行走无碍。大多数患者被告知在行走时不要承受正常的体重。膝关节可能需要用针（前面提到）排出关节中的血液。
Most patients receive physical therapy after having an ACL injury. Therapists treat swelling and pain with the use of ice, electrical stimulation, and rest periods with your leg supported in elevation.
大多数患者在ACL受伤后会接受物理治疗。治疗师使用冰敷、电刺激和抬高患肢休息一段时间治疗肿胀和疼痛。
Exercises are used to help you regain normal movement of joints and muscles. Range-of-motion exercises should be started right away with the goal of helping you swiftly regain full movement in your knee. This includes the use of a stationary bike, gentle stretching, and careful pressure applied to the knee by the therapist. Exercises are also given to improve the strength of the hamstring and quadriceps muscles. As your symptoms ease and strength improves, you will be guided in specialized exercises to improve knee stability.
锻炼有助于恢复关节和肌肉的正常活动。应立即开始一系列的运动，目的是帮助您迅速恢复膝关节的完整运动。这包括使用固定式自行车，轻柔地伸展，以及治疗师对膝盖施加压力。锻炼还能提高腘绳肌和股四头肌的力量。随着症状缓解和力量提高，可指导患者进行专门的练习，以提高膝关节的稳定性。
An ACL brace may be suggested. This type of brace is usually custom-made and not the type you can buy at the drugstore. It is designed to improve knee stability when the ACL doesn’t function properly. An ACL brace is often recommended when the knee is unstable and surgery is not planned. As mentioned, a torn ACL that isn’t corrected often leads to early knee arthritis. There is no evidence that an ACL brace will prevent further damage to the knee due to wear and tear arthritis. The ACL brace may help keep the knee from giving way during moderate activity. However, it can give a false sense of security and won’t always protect the knee during sports that require heavy cutting, jumping, or pivoting. Many orthopedists will also recommend wearing a brace for at least one year after a surgical reconstruction, so even if you decide to have ACL surgery, a brace is probably a good investment.
可能会建议使用ACL支具。这种支具通常是定制的，而不是您可以在药房购买的类型。它是为了在ACL无法正常工作时提高膝盖稳定性。当膝关节不稳定并且未计划手术时，通常建议使用ACL支具。如前所述，ACL撕裂未经矫正通常导致早期膝关节炎。没有证据表明ACL支具能防止由于磨损和撕裂引起的关节炎对膝关节的进一步损伤。ACL支具可能有助于在中度活动期间保持膝关节的稳定。然而，它可能给人一种虚假的安全感，且不是总能在需要过度剪切，跳跃或旋转的运动过程中保护膝关节。许多骨科医生还会建议在外科手术重建后佩戴支具至少１年，所以即使您决定进行ACL手术，支具可能是一个很好的投资。
手术
If the symptoms of instability are not controlled by a brace and rehabilitation program, then surgery may be suggested. The main goal of surgery is to keep the tibia from moving too far forward under the femur bone and to get the knee functioning normally again.
如果支具和康复治疗不能缓解膝关节不稳症状，外科医生可能会建议手术。手术的主要目的是防止胫骨在股骨下方向前移动得太远，并使膝关节功能恢复正常。
Even when surgery is needed, most surgeons will have their patients attend physical therapy for several visits before the surgery. This is done to reduce swelling and to make sure you can straighten your knee completely. This practice also reduces the chances of scarring inside the joint and can speed recovery after surgery.
即使需要手术，大多数外科医生将在患者手术前让患者进行几次物理治疗。这样做可以减少肿胀，并确保您可以完全伸直膝关节。这种做法也降低了关节内瘢痕形成的机会，并可以在手术后加速恢复。
Arthroscopic Method
关节镜手术
Most surgeons now favor reconstruction of the ACL using a piece of tendon or ligament to replace the torn ACL. This surgery is most often done with the aid of the arthroscope. Incisions are usually still required around the knee, but the surgery doesn’t require the surgeon to open the joint. The arthroscope is used to view the inside of the knee joint as the surgeon performs the work. Most ACL surgeries are now done on an outpatient basis, and many patients go home the same day as the surgery. Some patients stay one or two nights in the hospital if necessary.
大多数外科医生现在倾向于使用一条肌腱或韧带重建ACL，来代替被撕裂的ACL。这种手术通常在关节镜辅助下完成。膝关节周围通常仍然需要切口，但手术不需要外科医生打开关节。当外科医生进行手术时，用关节镜观察膝关节的内部。大多数ACL手术现在可以在门诊手术室完成，许多患者在手术当天就回家了。必要时有些病人会在医院住１～２天。
Patellar Tendon Graft
髌腱移植
One type of graft used to replace the torn ACL is the patellar tendon. This tendon connects the kneecap (patella) to the tibia. The surgeon removes a strip from the center of the ligament to use as a replacement for the torn ACL.
髌腱是一种用于替代撕裂ACL的移植物。该肌腱将膝盖（髌骨）连接到胫骨。外科医生从韧带的中心切取一条，用来替代被撕裂的ACL。
Related Document: A Patient’s Guide to Patellar Tendon Graft Reconstruction of the ACL
相关文章：髌腱移植重建前交叉韧带患者指南（翻译招募中，有意者留言）
骨科手术早知道034：前交叉韧带重建术ACL RECONSTRUCTION (PATELLAR TENDON GRAFT )
Hamstring Tendon Graft
腘绳肌腱移植
Surgeons also commonly use a hamstring graft to reconstruct a torn ACL. This graft is taken from one of the hamstring tendons that attaches to the tibia just below the knee joint. The hamstring muscles run down the back of the thigh. Their tendons cross the knee joint and connect on each side of the tibia. The graft used in ACL reconstruction is taken from the hamstring tendon, called thesemitendinosus. This tendon runs along the inside part of the thigh and knee. Surgeons also commonly include as part of the hamstring graft a tendon just next to the semitendinousus, called the gracilis. When arranged into three or four strips, the hamstring graft has nearly the same strength as a patellar tendon graft.
外科医生也常常使用腘绳肌腱移植来重建被撕裂的ACL。该移植物取自在膝关节正下方附着于胫骨的腘绳肌腱之一。腘绳肌行走于大腿后面，其肌腱穿过膝关节并连接在胫骨的一侧。在ACL重建中使用的移植物取自半腱肌腱。这条肌腱走行于大腿和膝关节的内侧。外科医生也通常将紧邻半腱肌腱的肌腱（称为股薄肌）作为腘绳肌腱移植物的一部分。当排列成三条或四条时，腘绳肌腱移植物具有与髌腱移植物几乎相同的强度。
Related Document: A Patient’s Guide to Hamstring Tendon Graft Reconstruction of the ACL
中英文字幕：使用腘绳肌腱重建前十字韧带（ACL Reconstruction with Hamstring）
中英文字幕：使用腘绳肌腱重建ACL（ARTHROTEK® and EZLoc™ Devices）
Allograft Reconstruction
同种异体移植物重建
Other materials are also used to replace the torn ACL. In some cases, an allograftis used. An allograft is tissue that comes from someone else. This tissue is harvested from tissue and organ donors at the time of death and sent to a tissue bank. The tissue is checked for any type of infection, sterilized, and stored in a freezer. When needed, the tissue is ordered by the surgeon and used to replace the torn ACL. The allograft (your surgeon’s choice of graft) can be from the tibialis tendon, patellar tendon, hamstring tendon, or Achilles tendon (the tendon that connects the calf muscles to the heel).
其他材料也被用来代替撕裂的ACL。在某些情况下，会使用同种异体移植物。同种异体移植物是来自别人的组织。在组织和器官捐赠者死亡时收集该组织并送至组织库。对移植组织进行检查，排除任何类型的感染，进行灭菌，并冷冻保存。当需要时，外科医生对组织进行编排，用于替代撕裂的ACL。同种异体移植物（您的外科医生选择的移植物）可以来自胫骨肌腱，髌腱，腘绳肌腱或跟腱（将小腿肌肉连接到脚后跟的肌腱）。
Many surgeons use patellar tendon allograft tissue because the tendon comes with the original bone still attached on each end of the graft (from the patella and from the tibia). This makes it easier to fix the allograft in place.
许多外科医生使用髌腱同种异体移植组织，因为移植肌腱附着的每一端（髌骨端和胫骨端）原先都附着有骨骼。这使得更容易将同种异体移植物固定到位。
The advantage of using an allograft is that the surgeon does not have to disturb or remove any of the normal tissue from your knee to use as a graft. The operation also usually takes less time because the graft does not need to be harvested from your knee.
使用同种异体移植物的优点是外科医生不必从您的膝关节中去除任何正常组织用作移植物而影响膝关节。手术时间更短，因为移植物不需要从您的膝关节切取。
What should I expect after treatment?
我治疗后有什么样的结果？
非手术治疗的康复
Nonsurgical rehabilitation for a torn ACL will typically last six to eight weeks. Therapists apply treatments such as electrical stimulation and ice to reduce pain and swelling. Exercises to improve knee range of motion and strength are added gradually. If your doctor prescribes a brace, your therapist will work with you to obtain and use the brace.
ACL撕裂的非手术康复通常将持续６～８周。治疗师应用电刺激和冰敷以减轻疼痛和肿胀。通过运动逐渐改善膝关节运动范围和力量。如果您的医生嘱咐用支具，您的治疗师指导您如何获取支具并使用。
You can return to your sporting activities when your quadriceps and hamstring muscles are back to nearly their full strength and control, you are not having swelling that comes and goes, and you aren’t having problems with the knee giving way.
当您的股四头肌和腘绳肌腱力量和控制几乎完全恢复时，就可以恢复体育运动。您将不会再有反复肿胀，膝关节也不会再有乏力不稳等问题。
术后康复
Most doctors have their patients take part in formal physical therapy after ACL reconstruction. You will probably be involved in a progressive rehabilitation program for four to six months after surgery to ensure the best result from your ACL reconstruction. At first, expect to see the physical therapist two to three times a week. If your surgery and rehabilitation go as planned during the first six weeks, you may only need to do a home program and see your therapist every few weeks over the four to six month period.
大多数医生让患者在ACL重建后进行正式的物理治疗。您可能会在手术后４～６个月参与渐进的康复计划，以确保ACL重建的最佳疗效。起初，安排每周看２～３次理疗师。如果您的手术和康复治疗在前６周内按计划进行，经过４～６个月，您可能只需要在家里自我锻炼，并每隔几周接受治疗师的指导。
（范亚杰 翻译 胡佰文 校对）
范亚杰，男，安徽阜阳人，骨科硕士研究生，从事骨科临床与基础研究，在国内核心期刊发表文章6篇。
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