Petersen Wolf, Zantop Thore
Department of Trauma, Hand, and Reconstructive Surgery, West-falian Wilhelms University Muenster, Muenster, Germany.
Clin Orthop Relat Res. 2007 Jan;454:35-47. doi: 10.1097/BLO.0b013e31802b4a59.
The anterior cruciate ligament (ACL) consists of two major fiber bundles, namely the anteromedial and posterolateral bundle. When the knee is extended, the posterolateral bundle (PL) is tight and the anteromedial (AM) bundle is moderately lax. As the knee is flexed, the femoral attachment of the ACL becomes a more horizontal orientation; causing the AM bundle to tighten and the PL bundle to relax. There is some degree of variability for the femoral origin of the anterome-dial and posterolateral bundle. The anteromedial bundle is located proximal and anterior in the femoral ACL origin (high and deep in the notch when the knee is flexed at 90 degrees ); the posterolateral bundle starts in the distal and posterior aspect of the femoral ACL origin (shallow and low when the knee is flexed at 90 degrees ). In the frontal plane the anteromedial bundle origin is in the 10:30 clock position and the postero-lateral bundle origin in the 9:30 clock position. At the tibial insertion the ACL fans out to form the foot region. The anteromedial bundle insertion is in the anterior part of the tibial ACL footprint, the posterolateral bundle in the posterior part. While the anteromedial bundle is the primary restraint against anterior tibial translation, the posterolateral bundle tends to stabilize the knee near full extension, particularly against rotatory loads.
前交叉韧带（ACL）由两个主要纤维束组成，即前内侧束和后外侧束。当膝关节伸直时，后外侧束（PL）紧张，前内侧束（AM）适度松弛。随着膝关节屈曲，ACL的股骨附着点变为更水平的方向；导致AM束紧张，PL束松弛。前内侧束和后外侧束的股骨起源存在一定程度的变异性。前内侧束位于股骨ACL起源的近端和前方（膝关节屈曲90度时在髁间凹的高处和深处）；后外侧束起始于股骨ACL起源的远端和后方（膝关节屈曲90度时在髁间凹的浅处和低处）。在额状面上，前内侧束的起源位于10:30位置，后外侧束的起源位于9:30位置。在胫骨附着处，ACL呈扇形散开形成足部区域。前内侧束附着于胫骨ACL足迹的前部，后外侧束附着于后部。虽然前内侧束是防止胫骨向前移位的主要限制因素，但后外侧束倾向于在膝关节接近完全伸直时稳定膝关节，特别是抵抗旋转负荷。
