Tschauner Sebastian, Sorantin Erich, Singer Georg, Eberl Robert, Weinberg Annelie-Martina, Schmidt Peter, Kraus Tanja
Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Auenbruggerplatz 34, 8036, Graz, Austria.
Department of Pediatric and Adolescence Surgery, Medical University of Graz, Graz, Austria.
Knee Surg Sports Traumatol Arthrosc. 2016 Jan;24(1):18-25. doi: 10.1007/s00167-014-2991-8. Epub 2014 Apr 18.
Different femoral origins for both the medial collateral ligament (MCL) and the lateral collateral ligament (LCL) have been reported in the growing skeleton (epiphyseal and metaphyseal). Knowledge about the exact attachment sites is mandatory for anatomically correct reconstruction. This study assesses the femoral origins of the knee collateral ligaments in skeletally immature individuals using magnetic resonance imaging (MRI).
MRIs of 336 knee joints (median age 15 years (range 2-18 years), m = 209 and f = 127) were retrospectively analysed to assess the distances between the femoral origins of the MCL and LCL to the distal femoral growth plate. In 175 patients, the body sizes were additionally retrieved from medical records.
Both MCL and LCL ligament origins were invariably located on the epiphysis. Mean MCL origin-growth plate distance was 9.6 mm (SD 2.1 mm; range 2.2-13.6 mm) in boys and 8.6 mm (SD 1.5 mm; range 3.4-12.0 mm) in girls. Mean LCL origin-growth plate distance was 9.3 mm (SD 1.8 mm; range 4.3-13.0 mm) in boys and 8.2 mm (SD 1.5 mm; range 3.4-11.8 mm) in girls. The distance between the growth plate and both collateral ligaments as well as the length of the LCL correlated positively with patients' age and body size (MCL R(2) = 0.673 and 0.556, LCL R (2) = 0.734 and 0.645, LCL length R(2) = 0.589 and 0.741; all p < 0.001).
During growth, the femoral origins of the MCL and the LCL are constantly located on the distal femoral epiphysis. There is a linear increase in the distances from the ligaments' origins to the growth plate according to age and body size. This new information may be of clinical importance for reconstructive surgery of the knee's collateral ligaments.
在生长中的骨骼（骨骺和干骺端）中，内侧副韧带（MCL）和外侧副韧带（LCL）的股骨起始点存在差异。了解确切的附着部位对于解剖学上正确的重建至关重要。本研究使用磁共振成像（MRI）评估骨骼未成熟个体膝关节副韧带的股骨起始点。
回顾性分析336个膝关节的MRI（中位年龄15岁（范围2 - 18岁），男性209例，女性127例），以评估MCL和LCL的股骨起始点与股骨远端生长板之间的距离。在175例患者中，还从病历中获取了身体尺寸信息。
MCL和LCL的韧带起始点均始终位于骨骺上。男孩的MCL起始点与生长板的平均距离为9.6毫米（标准差2.1毫米；范围2.2 - 13.6毫米），女孩为8.6毫米（标准差1.5毫米；范围3.4 - 12.0毫米）。男孩的LCL起始点与生长板的平均距离为9.3毫米（标准差1.8毫米；范围4.3 - 13.0毫米），女孩为8.2毫米（标准差1.5毫米；范围3.4 - 11.8毫米）。生长板与两条副韧带之间的距离以及LCL的长度与患者的年龄和身体尺寸呈正相关（MCL的R² = 0.673和0.556，LCL的R² = 0.734和0.645，LCL长度的R² = 0.589和0.741；所有p < 0.001）。
在生长过程中，MCL和LCL的股骨起始点始终位于股骨远端骨骺上。从韧带起始点到生长板的距离随年龄和身体尺寸呈线性增加。这一新信息对于膝关节副韧带的重建手术可能具有临床重要性。
