Saigo Takaaki, Tajima Goro, Kikuchi Shuhei, Yan Jun, Maruyama Moritaka, Sugawara Atsushi, Doita Minoru
Department of Orthopaedic Surgery, Iwate Medical University, Morioka, Japan.
Department of Orthopaedic Surgery, Iwate Medical University, Morioka, Japan.
Arthroscopy. 2017 Feb;33(2):400-407. doi: 10.1016/j.arthro.2016.07.030. Epub 2016 Oct 22.
To describe the insertions of the superficial medial collateral ligament (sMCL) and posterior oblique ligament (POL) and their related osseous landmarks.
Insertions of the sMCL and POL were identified and marked in 22 unpaired human cadaveric knees. The surface area, location, positional relations, and morphology of the sMCL and POL insertions and related osseous structures were analyzed on 3-dimensional images.
The femoral insertion of the POL was located 18.3 mm distal to the apex of the adductor tubercle (AT). The femoral insertion of the sMCL was located 21.1 mm distal to the AT and 9.2 mm anterior to the POL. The angle between the femoral axis and femoral insertion of the sMCL was 18.6°, and that between the femoral axis and the POL insertion was 5.1°. The anterior portions of the distal fibers of the POL were attached to the fascia cruris and semimembranosus tendon, whereas the posterior fibers were attached to the posteromedial side of the tibia directly. The tibial insertion of the POL was located just proximal and medial to the superior edge of the semimembranosus groove. The tibial insertion of the sMCL was attached firmly and widely to the tibial crest. The mean linear distances between the tibial insertion of the POL or sMCL and joint line were 5.8 and 49.6 mm, respectively.
This study used 3-dimensional images to assess the insertions of the sMCL and POL and their related osseous landmarks. The AT was identified clearly as an osseous landmark of the femoral insertions of the sMCL and POL. The tibial crest and semimembranosus groove served as osseous landmarks of the tibial insertions of the sMCL and POL.
By showing further details of the anatomy of the knee, the described findings can assist surgeons in anatomic reconstruction of the sMCL and POL.
描述浅层内侧副韧带（sMCL）和后斜韧带（POL）的附着点及其相关骨性标志。
在22个未配对的人类尸体膝关节中识别并标记sMCL和POL的附着点。在三维图像上分析sMCL和POL附着点及相关骨性结构的表面积、位置、位置关系和形态。
POL的股骨附着点位于内收肌结节（AT）顶点远侧18.3 mm处。sMCL的股骨附着点位于AT远侧21.1 mm且在POL前方9.2 mm处。sMCL股骨附着点与股骨干轴线的夹角为18.6°，POL附着点与股骨干轴线的夹角为5.°。POL远端纤维的前部附着于小腿筋膜和半膜肌腱，而后部纤维直接附着于胫骨后内侧。POL的胫骨附着点位于半膜肌沟上缘的近端和内侧。sMCL的胫骨附着点牢固且广泛地附着于胫骨嵴。POL或sMCL胫骨附着点与关节线之间的平均直线距离分别为5.8和49.6 mm。
本研究使用三维图像评估sMCL和POL的附着点及其相关骨性标志。AT被明确确定为sMCL和POL股骨附着点的骨性标志。胫骨嵴和半膜肌沟作为sMCL和POL胫骨附着点的骨性标志。
通过展示膝关节解剖结构的更多细节，所述研究结果可协助外科医生对sMCL和POL进行解剖重建。
