Ahmad Christopher S, Cohen Zohara A, Levine William N, Gardner Thomas R, Ateshian Gerard A, Mow Van C
Center for Shoulder, Elbow, and Sports Medicine, Department of Orthopaedic Surgery and Orthopaedic Research Laboratory, Columbia University, New York, New York 10032, USA.
Am J Sports Med. 2003 Mar-Apr;31(2):221-5. doi: 10.1177/03635465030310021101.
It is unclear how each bundle of the posterior cruciate ligament contributes to posterior knee stability.
Changes in bundle orientation and length occur such that neither bundle dominates in restraining posterior tibial motion throughout knee flexion and extension.
Controlled laboratory study.
Six fresh-frozen cadaveric knees were studied in a joint-testing rig with individual quadriceps and hamstring muscle loading. Kinematic data for the tibia and femur were obtained at knee flexion angles from 0 degrees to 120 degrees. The joint was then disarticulated, and the insertions of the two bundles on the tibia and femur were digitized.
Length of the anterolateral bundle increased with increasing knee flexion angle from 10 degrees to 120 degrees. Length of the posteromedial bundle decreased with increasing knee flexion angle from 0 degrees to 45 degrees and increased slightly from 60 degrees to 120 degrees. Length of the anteromedial bundle was significantly less than that of the posteromedial at 0 degrees, 10 degrees, and 20 degrees of knee flexion. The anterolateral bundle was significantly more horizontal at flexion angles of 0 degrees, 10 degrees, 20 degrees, 30 degrees, and 45 degrees (P < 0.05). The posteromedial bundle was more horizontal at 120 degrees.
Changes in orientation take place such that neither bundle dominates in restraining posterior tibial motion throughout knee flexion and extension.
Double-bundle reconstructions achieve more physiologic knee function.
目前尚不清楚后交叉韧带的每一束对膝关节后方稳定性的贡献如何。
束的方向和长度会发生变化，使得在膝关节屈伸过程中，没有一束在限制胫骨后移方面起主导作用。
对照实验室研究。
在一个带有单独股四头肌和腘绳肌加载装置的关节测试装置中，对6个新鲜冷冻的尸体膝关节进行研究。在膝关节从0度屈曲到120度的过程中，获取胫骨和股骨的运动学数据。然后将关节离断，对两束韧带在胫骨和股骨上的附着点进行数字化处理。
前外侧束的长度在膝关节屈曲角度从10度增加到120度时增加。后内侧束的长度在膝关节屈曲角度从0度增加到45度时减少，在60度到120度时略有增加。在膝关节屈曲0度、10度和20度时，前内侧束的长度明显短于后内侧束。在屈曲角度为0度、10度、20度、30度和45度时，前外侧束明显更水平（P < 0.05）。后内侧束在120度时更水平。
束的方向发生变化，使得在膝关节屈伸过程中，没有一束在限制胫骨后移方面起主导作用。
双束重建可实现更接近生理状态的膝关节功能。
