Orthopaedic and Sports Medicine Clinic of Kansas City, Leawood, KS 66211, USA.
Am J Sports Med. 2012 Jan;40(1):222-31. doi: 10.1177/0363546511416316. Epub 2011 Jul 29.
The optimal treatment of posterior cruciate ligament ruptures remains controversial despite numerous recent basic science advances on the topic. The current literature on the anatomy, biomechanics, and clinical outcomes of posterior cruciate ligament reconstruction is reviewed. Recent studies have quantified the anatomic location and biomechanical contribution of each of the 2 posterior cruciate ligament bundles on tunnel placement and knee kinematics during reconstruction. Additional laboratory and cadaveric studies have suggested double-bundle reconstructions of the posterior cruciate ligament may better restore normal knee kinematics than single-bundle reconstructions although clinical outcomes have not revealed such a difference. Tibial inlay posterior cruciate ligament reconstructions (either open or arthroscopic) are preferred by many authors to avoid the "killer turn" and graft laxity with cyclic loading. Posterior cruciate ligament reconstruction improves subjective patient outcomes and return to sport although stability and knee kinematics may not return to normal.
尽管最近在该领域有大量基础科学进展，但后交叉韧带撕裂的最佳治疗方法仍存在争议。本文回顾了后交叉韧带重建的解剖学、生物力学和临床结果的最新文献。最近的研究已经量化了在重建过程中每个后交叉韧带 2 束的解剖位置和生物力学贡献。其他实验室和尸体研究表明，与单束重建相比，后交叉韧带双束重建可能更好地恢复正常的膝关节运动学，但临床结果并未显示出这种差异。许多作者更喜欢胫骨嵌塞后交叉韧带重建（开放或关节镜），以避免“杀手转角”和循环加载时的移植物松弛。尽管稳定性和膝关节运动学可能无法恢复正常，但后交叉韧带重建可改善患者的主观结果和重返运动。
