Staeubli H U, Adam O, Becker W, Burgkart R
Orthopaedics and Traumatology, Surgical Clinic and Department of Radiology, Tiefenauspital, Bern, Switzerland.
Arthroscopy. 1999 May;15(4):349-59. doi: 10.1016/s0749-8063(99)70051-4.
We assessed the anatomy of the anterior cruciate ligament (ACL) and femoral intercondylar notch on cryosections from one cadaveric knee specimen in the coronal oblique plane oriented parallel to the intercondylar roof. We determined the course of the ACL, the widths of the cruciate ligaments at intersection, and the intercondylar notch configuration on coronal oblique plane magnetic resonance images in 51 adult cruciate ligament-intact knees (25 women, 26 men; age range, 16 to 47 years). The intercondylar notch widths were measured at the notch entrance, at the intersection of the ACL and posterior cruciate ligament (PCL), and at the notch outlet. In the coronal oblique plane, the ACL exhibited a diagonal course from the central and medial part of the anterior intercondylar area of the tibia distally, across the lateral third of the intercondylar notch, to the intercondylar surface of the lateral femoral condyle proximally. At the cruciate ligament intersection, the absolute widths of the ACLs measured on average 6.1+/-1.1 mm in men and 5.2+/-1.0 mm in women representing 31.9% and 31.1% of the ACL/central intercondylar notch width ratios. The absolute widths of the PCLs measured on average 9.6+/-1.3 mm in men and 8.5+/-1.3 mm in women representing 50.4% and 51.4% of PCL/central intercondylar notch width ratios. On average for both groups, men and women, the absolute widths of the PCLs were significantly larger than the absolute widths of the ACLs. However, the relative widths of the cruciate ligaments with respect to corresponding intercondylar notch widths were not significantly different. In the coronal oblique plane, the intercondylar notch widths showed on average a significant decrease from posterior to intersection and from intersection to anterior. At notch outlet, the mean notch width measured 21.4 mm in men and 18.5 mm in women. At intersection, the mean notch width measured 19.1 mm in men and 16.6 mm in women. At notch entrance, the notch width measured 14.6+/-1.8 mm in men and 12.7+/-2.1 mm in women. We recommend magnetic resonance tomography of the knee in the coronal oblique plane oriented parallel to the intercondylar roof as the imaging modality of choice to visualize accurately the anatomic diagonal course of the ACL and its relation to the intercondylar notch and posterior cruciate ligament complex.
我们在一个尸体膝关节标本的冠状斜面上评估了前交叉韧带（ACL）和股骨髁间切迹的解剖结构，该冠状斜面与髁间顶平行。我们确定了51例成人交叉韧带完整的膝关节（25名女性，26名男性；年龄范围16至47岁）在冠状斜位磁共振图像上ACL的走行、交叉处交叉韧带的宽度以及髁间切迹形态。在切迹入口、ACL与后交叉韧带（PCL）交叉处以及切迹出口测量髁间切迹宽度。在冠状斜面上，ACL呈对角线走行，从胫骨髁间前区的中央和内侧部分向远端，穿过髁间切迹的外侧三分之一，向近端至股骨外侧髁的髁间表面。在交叉韧带交叉处，男性ACL的绝对宽度平均为6.1±1.1mm，女性为5.2±1.0mm，分别占ACL/中央髁间切迹宽度比的31.9%和31.1%。男性PCL的绝对宽度平均为9.6±1.3mm，女性为8.5±1.3mm，分别占PCL/中央髁间切迹宽度比的50.4%和51.4%。两组（男性和女性）平均而言，PCL的绝对宽度显著大于ACL的绝对宽度。然而，交叉韧带相对于相应髁间切迹宽度的相对宽度无显著差异。在冠状斜面上，髁间切迹宽度平均从后部到交叉处以及从交叉处到前部均有显著减小。在切迹出口处，男性髁间切迹平均宽度为21.4mm，女性为18.5mm。在交叉处，男性髁间切迹平均宽度为19.1mm，女性为16.6mm。在切迹入口处，男性髁间切迹宽度为14.6±1.8mm，女性为12.7±2.1mm。我们建议将与髁间顶平行的冠状斜位膝关节磁共振断层扫描作为首选的成像方式，以准确显示ACL的解剖对角线走行及其与髁间切迹和后交叉韧带复合体的关系。
