Movement Analysis Laboratory, Centro di Ricerca Codivilla-Putti, Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy.
J Biomech. 2012 Jul 26;45(11):1886-92. doi: 10.1016/j.jbiomech.2012.05.029. Epub 2012 Jun 5.
Patterns of fibre elongation and orientation for the cruciate and collateral ligaments of the human knee joint and for the patellar tendon have not yet been established in three-dimensions. These patterns are essential for understanding thoroughly the contribution of these soft tissues to joint function and of value in surgical treatments for a more conscious assessment of the knee status. Measurements from 10 normal cadaver knees are here reported using an accurate surgical navigation system and consistent anatomical references, over a large flexion arc, and according to current recommended conventions. The contours of relevant sub-bundles were digitised over the corresponding origins and insertions on the bones. Representative fibres were calculated as the straight line segments joining the centroids of these attachment areas. The most isometric fibre was also taken as that whose attachment points were at the minimum change in length over the flexion arc. Changes in length and orientation of these fibres were reported versus the flexion angle. A good general repeatability of intra- and inter-specimens was found. Isometric fibres were found in the locations reported in the literature. During knee flexion, ligament sub-bundles slacken in the anterior cruciate ligament, and in the medial and lateral collateral ligaments, whereas they tighten in the posterior cruciate ligament. In each cruciate ligament the two compounding sub-bundles have different extents for the change in fibre length, and also bend differently from each other on both tibial planes. In the collateral ligaments and patellar tendon all fibres bend posteriorly. Patellar tendon underwent complex changes in length and orientation, on both the tibial sagittal and frontal planes. For the first time thorough and consistent patterns of geometrical changes are provided for the main knee ligaments and tendons after careful fibre mapping.
在三维空间中，尚未确定人膝关节的十字韧带和侧副韧带以及髌腱的纤维伸长和定向模式。这些模式对于彻底了解这些软组织对关节功能的贡献以及对更有意识地评估膝关节状况的手术治疗非常重要。在此报道了使用准确的手术导航系统和一致的解剖参考，在较大的弯曲弧上，并根据当前推荐的惯例，对 10 个正常尸体膝关节的测量结果。在相应的骨骼上对相关子束的轮廓进行了数字化处理。代表性纤维被计算为连接这些附着区域质心的直线段。等长纤维也被认为是其附着点在弯曲弧上长度变化最小的纤维。报告了这些纤维的长度和方向变化与弯曲角度的关系。发现了良好的内标和标本间的可重复性。在文献中报道的位置发现了等长纤维。在膝关节弯曲过程中，前交叉韧带、内侧和外侧副韧带中的韧带子束松弛，而后交叉韧带中的韧带子束收紧。在每个十字韧带中，两个复合子束的纤维长度变化程度不同，并且在两个胫骨平面上彼此弯曲方式也不同。在侧副韧带和髌腱中，所有纤维都向后弯曲。髌腱在胫骨矢状面和额状面上都经历了复杂的长度和方向变化。首次提供了主要膝关节韧带和肌腱的彻底和一致的几何变化模式，经过仔细的纤维映射。
