Zavras T D, Race A, Bull A M, Amis A A
Mechanical Engineering Department, Imperial College of Science, Technology and Medicine, London, UK.
Knee Surg Sports Traumatol Arthrosc. 2001;9(1):28-33. doi: 10.1007/s001670000170.
Anterior cruciate ligament (ACL) reconstruction depends critically on isometric graft placement. Unfortunately, different supposedly isometric points have been published, and no prior work has compared them to find out which are really isometric. The purpose of this study was to compare the isometry of previously published 'isometric' points for ACL reconstruction. The isometric points and knee loadings of previous studies were reproduced accurately in 12 fresh cadaveric knees. The length changes were measured through 140 degrees knee flexion, using an intra-articular suture attached to a displacement transducer. Six points had less than 1 mm length change and were located proximally in the natural ACL attachment at the posterior end of Blumensaat's line. The other seven points had length change patterns that would cause ACL graft tightening or slackening with knee flexion if they were used as the sites of bone tunnels for graft placement. This study confirms the existence of an isometric zone close to the posterior end of Blumensaat's line under several loading conditions. Other graft attachment points are less suitable for ACL reconstruction.
前交叉韧带（ACL）重建手术的关键在于移植肌腱的等距放置。遗憾的是，虽然已经发表了不同的所谓等距点，但此前尚无研究对它们进行比较以确定哪些才是真正的等距点。本研究旨在比较先前发表的用于ACL重建的“等距”点的等距性。在12具新鲜尸体膝关节中精确重现了先前研究中的等距点和膝关节负荷情况。通过连接位移传感器的关节内缝线，测量膝关节在140度屈曲过程中的长度变化。有六个点的长度变化小于1毫米，它们位于Blumensaat线后端自然ACL附着点的近端。另外七个点的长度变化模式表明，如果将它们用作移植肌腱骨隧道的位置，在膝关节屈曲时会导致ACL移植物收紧或松弛。本研究证实，在多种负荷条件下，靠近Blumensaat线后端存在一个等距区域。其他移植物附着点不太适合用于ACL重建。
