Teng Yuanjun, Guo Laiwei, Wu Meng, Xu Tianen, Zhao Lianggong, Jiang Jin, Sheng Xiaoyun, Xu Lihu, Zhang Bo, Ding Ning, Xia Yayi
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou City, No. 82 Cuiyingmen, Chengguan District, Lanzhou City, Gansu Province, 730030, China.
Orthopaedics Key Laboratory of Gansu Province, the Second Hospital of Lanzhou University, Lanzhou University, Lanzhou City, Gansu Province, 730030, China.
BMC Musculoskelet Disord. 2016 Sep 5;17(1):384. doi: 10.1186/s12891-016-1232-3.
Consistent reference data used for anatomic posterior cruciate ligament (PCL) reconstruction is not well defined. Quantitative guidelines defining the location of PCL attachment would aid in performing anatomic PCL reconstruction. The purpose was to characterize anatomic parameters of the PCL tibial attachment based on magnetic resonance imaging (MRI) in a large population of adult knees.
The PCL tibial attachment site was examined in 736 adult knees with an intact PCL using 3.0-T proton density-weighted sagittal MRI. The outcomes measured were the anterior-posterior diameter (APD) of the tibial plateau; angle between the tibial plateau and the posterior tibial 'shelf' (the slope where the PCL tibial attachment site was) (PTS); length of the PTS; proximal, central, and distal PCL attachment positions as well as the width of the PCL attachment site; and vertical dimension of the PCL attachment site inferior from the tibial plateau.
The average APD of the tibia plateau was 33.6 ± 3.5 mm, yielding significant differences between males (35.5 ± 3.0 mm) and females (31.6 ± 2.7 mm), P <.05, and there was a significantly decreasing trend with increasing age in males (P <.05). Mean angle between the tibial plateau and the PTS was 122.4° ± 8.1°, and subgroup analysis showed that the young group had a differently smaller angle (120.9° ± 7.5°) than the middle-aged (123.7° ± 8.2°) and the old (123.4° ± 7.7°) in males population, while there were no significant differences between sexes (P >.05). The proximal, central positions and width of the PCL attachment site were 13.4 ± 3.0 mm, 17.8 ± 3.0 mm and 9.6 ± 2.4 mm along the PTS, with significant differences between males and females (P <.05), and accounted for 60.0 % ± 9.1 %, 80.0 % ± 4.6 % and 43.3 % ± 9.7 % of the PTS respectively, with no significant differences between sexes and among age groups (all P >.05).
This study provides reference data of the tibial PCL attachment based on MRI in the sagittal orientation. In analysis of retrospective data from a large population of adult patients, the quantitative values can be used as references to define the inserted angle and depth of the drill guide, and the exact position and size of the tibial PCL tunnel for performing arthroscopic anatomic PCL reconstruction.
用于解剖学后交叉韧带（PCL）重建的一致参考数据尚未明确界定。定义PCL附着位置的定量指南将有助于进行解剖学PCL重建。目的是基于磁共振成像（MRI）对大量成年膝关节的PCL胫骨附着的解剖参数进行特征描述。
使用3.0-T质子密度加权矢状面MRI对736例PCL完整的成年膝关节的PCL胫骨附着部位进行检查。测量的结果包括胫骨平台的前后径（APD）；胫骨平台与胫骨后“平台”（PCL胫骨附着部位所在的斜坡）之间的角度（PTS）；PTS的长度；PCL附着的近端、中央和远端位置以及PCL附着部位的宽度；以及PCL附着部位距胫骨平台下方的垂直尺寸。
胫骨平台的平均APD为33.6±3.5mm，男性（35.5±3.0mm）和女性（31.6±2.7mm）之间存在显著差异，P<0.05，并且男性中随着年龄增长有显著下降趋势（P<0.05）。胫骨平台与PTS之间的平均角度为122.4°±8.1°，亚组分析显示，在男性人群中，年轻组的角度（120.9°±7.5°）明显小于中年组（123.7°±8.2°）和老年组（123.4°±7.7°），而性别之间无显著差异（P>0.05）。PCL附着部位的近端、中央位置和宽度沿PTS分别为13.4±3.0mm、17.
