Makris C A, Georgoulis A D, Papageorgiou C D, Moebius U G, Soucacos P N
Department of Orthopaedic Surgery, University of Ioannina Medical School, Ioannina, Greece.
Arthroscopy. 2000 Sep;16(6):627-32. doi: 10.1053/jars.2000.9238.
Our objective was to verify the fiber anatomy of the posterior cruciate ligament (PCL) and to measure the main dimensions and the femoral and tibial attachment site distances of the ligament after microsurgical dissection. We hypothesized that PCL anatomy is more complex than the 2 traditionally characterized bands.
This is a purely anatomic description of microdissections of the PCL, focused on the fine anatomy of the ligament.
Twenty-four fresh-frozen cadaveric knees were dissected using magnifying loupes and an operative microscope, being careful to avoid creating artificially separated bundles. The main dimensions of the PCL were measured using a micrometer.
The anterior, central, posterior-longitudinal, and posterior-oblique were the 4 fiber regions identified based on their orientation and the osseous sites of their insertions. These were partially separable anatomically but were functionally distinct. The anterior and central fiber regions made up the bulk of the ligament, while the remaining 15% consisted of the posterior fiber regions. During manual joint motion, the behavior of these fiber regions was observed. The anterior fiber region appeared to be the most nonisometric and remained in tension mainly between 30 degrees and 90 degrees of flexion. The posterior fiber regions appeared to be the most isometric (especially the posterior-oblique) and remained in tension mainly in extension and partially in deep flexion. The central fiber region appeared to have an intermediate behavior and remained in tension mainly between 30 degrees and 120 degrees of flexion. Additionally, it appeared to be the widest of all fiber regions.
These findings should be of interest and help in interpreting some of the anatomy encountered during arthroscopic examination of the PCL, both from the anterior and posterior lateral portals. Furthermore, this information should prove useful in selecting treatment for the PCL.
我们的目标是验证后交叉韧带（PCL）的纤维解剖结构，并在显微手术解剖后测量该韧带的主要尺寸以及股骨和胫骨附着点的距离。我们假设PCL的解剖结构比传统上描述的两条束带更为复杂。
这是一项对PCL显微解剖的纯解剖学描述，重点关注韧带的精细解剖结构。
使用放大镜和手术显微镜对24个新鲜冷冻的尸体膝关节进行解剖，注意避免人为分离束带。使用千分尺测量PCL的主要尺寸。
根据纤维的方向及其插入的骨位点，确定了前、中、后纵和后斜4个纤维区域。这些区域在解剖学上部分可分离，但功能上不同。前纤维区域和中央纤维区域构成了韧带的主体，而其余15%由后纤维区域组成。在手动关节活动过程中，观察了这些纤维区域的行为。前纤维区域似乎是最非等长的，主要在30度至90度屈曲之间保持张力。后纤维区域似乎是最等长的（尤其是后斜纤维区域），主要在伸展时以及部分在深度屈曲时保持张力。中央纤维区域似乎具有中间行为，主要在30度至120度屈曲之间保持张力。此外，它似乎是所有纤维区域中最宽的。
这些发现应具有重要意义，并有助于解释在通过前外侧和后外侧入路对PCL进行关节镜检查时遇到的一些解剖结构。此外，这些信息在选择PCL的治疗方法时应被证明是有用的。
