Takahashi Masaaki, Doi Mitsuhito, Abe Masashi, Suzuki Daisuke, Nagano Akira
Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, 431-3192, Japan.
Am J Sports Med. 2006 May;34(5):787-92. doi: 10.1177/0363546505282625. Epub 2006 Feb 1.
Recently, anatomical anterior cruciate ligament reconstruction with 2-bundle reconstruction has been proposed. Few previous publications have mentioned anatomical measurements of the insertions of these bundles.
To determine the precise anatomical measurements of the femoral and tibial insertions for anteromedial and posterolateral bundles of anterior cruciate ligament grafts.
Descriptive laboratory study.
Thirty-two femurs and 31 tibias were selected. The anterior cruciate ligament was divided into anteromedial and posterolateral bundles to the insertion footprint. Six measurements of the femoral insertion and 4 measurements of the tibial insertion were examined. Locations of the femoral insertions were examined using lateral radiographs of the femur.
The distance between the center of the femoral insertions of the anteromedial and posterolateral bundles and the posterior margin of the lateral femoral condyle averaged 7.6 and 7.0 mm, respectively. The distance between the center of the femoral insertions of the anteromedial and posterolateral bundles to the intercondylar roof averaged 4.1 and 11.3 mm, respectively. The sagittal distance between the center of the tibial insertions of the anteromedial and posterolateral bundles from the anterior margin of the tibial articular cartilage averaged 13.0 and 14.7 mm, respectively. The distance from the lateral margin of the articular cartilage of the tibial plateau to the center of the tibial insertions of the anteromedial and posterolateral bundles averaged 44.2% and 52.4% of the total widest width of the tibial plateau, respectively. On the lateral radiograph of femoral condyles, the center of the anteromedial bundle was located at 31.9% from the posterior margin of the femoral condyle and 26.9% from the roof, and that of the posterolateral bundle was located at 39.8% from the posterior margin of the femoral condyle and 53.2% from the roof.
It is important to know the precise anatomy of anterior cruciate ligament bundles when performing reconstruction and to evaluate anterior cruciate ligament reconstruction surgery on an anatomical basis.
最近，有人提出采用双束重建进行解剖学前交叉韧带重建。以往很少有出版物提及这些束的附着点的解剖学测量。
确定前交叉韧带移植物的前内侧束和后外侧束在股骨和胫骨附着点的精确解剖学测量值。
描述性实验室研究。
选取32根股骨和31根胫骨。将前交叉韧带在附着足迹处分为前内侧束和后外侧束。检查了股骨附着点的6项测量值和胫骨附着点的4项测量值。使用股骨侧位X线片检查股骨附着点的位置。
前内侧束和后外侧束在股骨附着点中心与外侧股骨髁后缘之间的距离平均分别为7.6和7.0毫米。前内侧束和后外侧束在股骨附着点中心与髁间顶之间的距离平均分别为4.1和11.3毫米。前内侧束和后外侧束在胫骨附着点中心与胫骨关节软骨前缘之间的矢状距离平均分别为13.0和14.7毫米。胫骨平台关节软骨外侧缘到前内侧束和后外侧束在胫骨附着点中心的距离分别平均占胫骨平台总最宽宽度的44.2%和52.4%。在股骨髁的侧位X线片上，前内侧束的中心位于距股骨髁后缘31.9%处和距髁顶26.9%处，后外侧束的中心位于距股骨髁后缘39.8%处和距髁顶53.2%处。
在进行重建时了解前交叉韧带束的精确解剖结构并在解剖学基础上评估前交叉韧带重建手术非常重要。
