Matsumoto H, Suda Y, Otani T, Niki Y, Seedhom B B, Fujikawa K
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
J Orthop Sci. 2001;6(1):28-32. doi: 10.1007/s007760170021.
Both the medial collateral ligament (MCL) and the anterior cruciate ligament (ACL) are reported to prevent valgus instability of the knee. In this study, the anatomical mechanisms by which these ligaments prevent valgus instability were experimentally investigated. The valgus rotation angle and the magnitude of the medial joint space opening were measured in six cadaveric knees, using biplanar photography before and after the MCL and/or the ACL were severed. A significant increase in the valgus rotation angle and a large medial joint space opening were observed when the MCL was severed. An increase in the valgus rotation angle was also observed when the ACL was severed, but only a small medial joint space opening was present. The increase in the valgus rotation angle after ACL severance was nearly parallel to the increase in the internal rotation of the tibia. Thus, we concluded that both ligaments function to prevent valgus instability, but that the anatomical reasons for their function are different. The MCL prevents valgus instability by stopping an opening in the medial joint space. The ACL, on the other hand, prevents the internal rotation of the tibia. When the ACL is severed, the internal rotation increases, and causes the valgus rotation angle to also increase, despite the presence of only a small medial joint space opening.
据报道，内侧副韧带（MCL）和前交叉韧带（ACL）均可防止膝关节外翻不稳定。在本研究中，通过实验研究了这些韧带防止外翻不稳定的解剖学机制。在切断MCL和/或ACL之前和之后，使用双平面摄影测量了六个尸体膝关节的外翻旋转角度和内侧关节间隙开口的大小。切断MCL时，观察到外翻旋转角度显著增加，内侧关节间隙开口增大。切断ACL时也观察到外翻旋转角度增加，但内侧关节间隙开口仅略有增大。ACL切断后外翻旋转角度的增加几乎与胫骨内旋的增加平行。因此，我们得出结论，两条韧带均起到防止外翻不稳定的作用，但其功能的解剖学原因不同。MCL通过阻止内侧关节间隙开口来防止外翻不稳定。另一方面，ACL可防止胫骨内旋。当ACL切断时，内旋增加，尽管内侧关节间隙开口仅略有增大，但仍会导致外翻旋转角度增加。
