Sheps David M, Otto David, Fernhout Mark
Division of Orthopaedics, The University of Alberta, Edmonton, Alberta, Canada.
Arthroscopy. 2005 Jul;21(7):820-5. doi: 10.1016/j.arthro.2005.04.105.
The purpose of the study was to better define the tibial insertion of the posterior cruciate ligament (PCL) and to identify landmarks that could be used to aid in placement of independent tibial tunnels for a 2-bundle PCL reconstruction.
Descriptive anatomic study.
Ten knees from 8 cadavers were dissected and the PCL was identified. The ligament was peeled away from its insertion and the sides of the insertion site were measured and recorded. The 4 corners of the insertion site were identified and marked. Observations were made of the morphology of the insertion site and the presence of any reproducible anatomic landmarks. A note was made of landmarks that could be easily identified on all of the specimens by direct vision and by palpation with a probe.
The ligament consisted of 2 regions, 1 anterolateral, and 1 posteromedial, with a gradual change in the laxity of the ligament as the knee was passed through flexion and extension. The insertion site was situated in a depression between the plateaus of the tibia and extended below the articular surface. The average length +/- standard deviation of the 4 sides was 128 +/- 21.2 mm (medial side), 107 +/- 26.5 mm (superior side), 160 +/- 30.0 mm (lateral side), and 169 +/- 34.5 mm (inferior side). The shape and sides of the insertion site were visually similar among the 10 specimens. The superolateral and superomedial corners were both represented by depressions and a reproducible ridge represented the inferior border. These structures could be visualized as well as palpated on all specimens.
Based on the findings of this study, we describe the anatomic characteristics of the tibial footprint of the PCL. Anatomic reference points that represent the corners of the tibial insertion of the PCL were identified by direct vision or palpation consistently on all specimens included in the study. These reference points could potentially aid in the placement of an anterolateral and posteromedial tibial tunnel for a 2 tibial tunnel PCL reconstruction.
Reproducible anatomic reference points exist at the tibial insertion of the PCL that can be identified by direct vision and palpation. These reference points may potentially aid in the placement of separate tibial tunnels for a 2-bundle PCL reconstruction.
本研究的目的是更准确地界定后交叉韧带（PCL）在胫骨的附着点，并确定可用于辅助为双束PCL重建放置独立胫骨隧道的标志点。
描述性解剖学研究。
对8具尸体的10个膝关节进行解剖，识别出PCL。将韧带从其附着处剥离，测量并记录附着部位的各边尺寸。确定并标记附着部位的四个角。观察附着部位的形态以及是否存在任何可重复的解剖标志。记录那些通过直接观察和用探针触诊能在所有标本上轻松识别的标志。
该韧带由两个区域组成，一个前外侧区域和一个后内侧区域，随着膝关节屈伸，韧带的松弛度逐渐变化。附着部位位于胫骨平台之间的凹陷处，并延伸至关节面下方。四条边的平均长度±标准差分别为：内侧边128±21.2毫米，上边107±26.5毫米，外侧边160±30.0毫米，下边169±34.5毫米。10个标本的附着部位形状和各边在视觉上相似。上外侧角和上内侧角均为凹陷，一条可重复的嵴代表下边界。这些结构在所有标本上都能看到并触诊到。
基于本研究结果，我们描述了PCL胫骨足迹的解剖特征。在本研究的所有标本上，通过直接观察或触诊始终能确定代表PCL胫骨附着点角的解剖参考点。这些参考点可能有助于为双胫骨隧道PCL重建放置前外侧和后内侧胫骨隧道。
在PCL的胫骨附着处存在可重复的解剖参考点，可通过直接观察和触诊识别。这些参考点可能有助于为双束PCL重建放置单独的胫骨隧道。
