Komzák Martin, Hart Radek, Okál František, Safi Adel
Department of Orthopaedic and Traumatologic Surgery, Hospital Znojmo, MUDr. Jana Jánského 11, Znojmo, 669 02, Czech Republic.
Knee. 2013 Dec;20(6):551-5. doi: 10.1016/j.knee.2013.03.012. Epub 2013 May 4.
The purpose of this study was to evaluate the influence of both bundles of the anterior cruciate ligament (ACL) on knee stability, anterior-posterior translation (APT) and internal (IR) and external (ER) rotation in cadaveric knees using a computer navigation system.
The APT, IR, and ER of the knees were recorded in the intact condition, the anterolateral bundle (AM) or the posterolateral bundle (PL) deficit condition and in the ACL-deficient condition. The KT-1000 arthrometer was used for APT evaluation. The measurement of rotational movements was done using a rollimeter. All tests were performed at 30°, 60° and 90° of flexion.
At 30° of flexion: In the intact knee APT was 5.8mm, IR 12.1°, ER 10.1°. After the AM was cut, the APT increased to 9.1mm, IR to 13.9° and ER to 12.6°. After the PL was cut, the APT was 6.4mm, IR 13.1° and ER 10.6°. After the AM and PL were cut, the APT was 10.8mm, IR 15.7° and the ER was 12.9° on average.
The AM has a greater impact on the APT than the PL in all knee joint flexion angles. The PL does not resist the rotational stability more than the AM. The rotational stability is better controlled by both bundles of ACL as compared to one bundle of the ACL.
This study acknowledges the fact that the both bundles of the ACL are importants for AP and rotational stability of the knee joint.
本研究的目的是使用计算机导航系统评估前交叉韧带(ACL)的两束对尸体膝关节稳定性、前后平移(APT)以及内旋(IR)和外旋(ER)的影响。
记录膝关节在完整状态、前外侧束(AM)或后外侧束(PL)缺失状态以及ACL缺失状态下的APT、IR和ER。使用KT-1000关节测量仪评估APT。使用旋转测量仪进行旋转运动的测量。所有测试均在30°、60°和90°屈膝状态下进行。
在30°屈膝时:完整膝关节的APT为5.8mm,IR为12.1°,ER为10.1°。切断AM后,APT增加到9.1mm,IR增加到13.9°,ER增加到12.6°。切断PL后,APT为6.4mm,IR为13.1°,ER为10.6°。切断AM和PL后,平均APT为10.8mm,IR为15.7°,ER为12.9°。
在所有膝关节屈曲角度下,AM对APT的影响大于PL。PL在抵抗旋转稳定性方面并不比AM更强。与ACL的一束相比,ACL的两束对旋转稳定性的控制更好。
本研究证实了ACL的两束对于膝关节前后和旋转稳定性都很重要这一事实。