LaPrade Robert F, Morgan Patrick M, Wentorf Fred A, Johansen Steinar, Engebretsen Lars
Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, R200, Minneapolis, MN 55454, USA.
J Bone Joint Surg Am. 2007 Apr;89(4):758-64. doi: 10.2106/JBJS.F.00120.
The orthopaedic literature contains relatively little quantitative information regarding the anatomy of the posterior aspect of the knee. The purpose of the present study was to provide a detailed description of, and to propose a standard nomenclature for, the anatomy of the posterior aspect of the knee.
Detailed dissection of twenty nonpaired, fresh-frozen knees was performed. Posterior knee structures were measured according to length, width, and/or distance to reproducible osseous landmarks.
The semimembranosus tendon had eight attachments distal to the main common tendon. The main components were a lateral expansion to the oblique popliteal ligament; a direct arm, which attached to the tibia; and an anterior arm. The oblique popliteal ligament, the largest posterior knee structure, formed a broad fascial sheath over the posterior aspect of the knee and measured 48.0 mm in length and 9.5 mm wide at its medial origin and 16.4 mm wide at its lateral attachment. It had two lateral attachments, one to the meniscofemoral portion of the posterolateral joint capsule and one to the tibia, along the lateral border of the posterior cruciate ligament facet. The semimembranosus also had a distal tibial expansion, which formed a posterior fascial layer over the popliteus muscle. A thickening of the posterior joint capsule, the proximal popliteus capsular expansion, which in this study averaged 40.5 mm in length, connected the posteromedial knee capsule at its attachment at the intercondylar notch to the medial border of the popliteus musculotendinous junction. The plantaris muscle, popliteofibular ligament, fabellofibular ligament, and semimembranosus bursa were present in all specimens.
The anatomy of the posterior aspect of the knee is quite complex. This study provides information that can lead to further biomechanical, radiographic imaging, and clinical studies of the importance of these posterior knee structures.
骨科文献中关于膝关节后方解剖结构的定量信息相对较少。本研究的目的是详细描述膝关节后方的解剖结构，并提出一个标准的命名法。
对20个未配对的新鲜冷冻膝关节进行了详细的解剖。根据长度、宽度和/或到可重复骨性标志的距离对膝关节后方结构进行测量。
半膜肌腱在主要共同肌腱远端有8个附着点。主要组成部分包括向斜腘韧带的外侧扩展；一条直接附着于胫骨的臂；以及一条前臂。斜腘韧带是膝关节后方最大的结构，在膝关节后方形成一个宽阔的筋膜鞘，长度为48.0毫米，内侧起点处宽9.5毫米，外侧附着处宽16.4毫米。它有两个外侧附着点，一个附着于后外侧关节囊的半月板股骨部分，另一个沿着后交叉韧带小关节面的外侧缘附着于胫骨。半膜肌还有一个远端胫骨扩展，在腘肌上形成一个后方筋膜层。后关节囊的增厚部分，即近端腘肌囊扩展，在本研究中平均长度为40.5毫米，将髁间切迹处附着的膝关节后内侧囊与腘肌肌腱结合部的内侧缘相连。所有标本中均存在跖肌、腘腓韧带、腓肠豆腓韧带和半膜肌滑囊。
膝关节后方的解剖结构相当复杂。本研究提供的信息可用于进一步开展关于这些膝关节后方结构重要性的生物力学、影像学和临床研究。
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