Stentz-Olesen Kasper, Nielsen Emil Toft, de Raedt Sepp, Jørgensen Peter Bo, Sørensen Ole Gade, Kaptein Bart, Søballe Kjeld, Stilling Maiken
Orthopedic Research Unit, Aarhus University Hospital, Tage Hansens Gade 2, 8000, Aarhus C, Denmark.
Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7 D2, 9220, Aalborg East, Denmark.
Knee Surg Sports Traumatol Arthrosc. 2017 Apr;25(4):1125-1131. doi: 10.1007/s00167-017-4500-3. Epub 2017 Mar 17.
Little is known about the anterolateral ligament's (ALL) influence on knee laxity. The purpose of this study was to investigate rotational knee laxity against a pure axial rotational stress using radiostereometric analysis (RSA) after cutting and reconstructing both the anterior cruciate ligament (ACL) and the ALL.
Eight human donor legs were positioned and stereoradiographically recorded at 0°, 30° and 60° of knee flexion using a motorised fixture, while an internally rotating force of 4 Nm was applied to the foot. Anterior-posterior and rotational laxity were investigated for knees with intact ligaments and compared with those observed after successive ACL and ALL resection and reconstruction.
After cutting the ALL in ACL-deficient knees, the internal rotation was increased in all three knee flexion angles, 0° (p = 0.04), 30° (p = 0.03) and 60° (p < 0.01) by 1.0°, 1.6° and 2.5°, respectively. However, no decrease in laxity was found after reconstructing the ALL in ACL-reconstructed knees.
The ALL was confirmed as a stabiliser of internal rotation in ACL-deficient knees. However, reconstructing the ALL using a gracilis autograft tendon did not decrease the internal rotation laxity in the ACL-reconstructed knee. Based on the results of this study, we do not recommend reconstructing the ALL in ACL-reconstructed knees to decrease internal knee laxity.
关于前外侧韧带（ALL）对膝关节松弛度的影响，目前所知甚少。本研究的目的是在切断并重建前交叉韧带（ACL）和ALL后，使用放射性立体测量分析（RSA）来研究膝关节在单纯轴向旋转应力下的旋转松弛度。
使用电动固定装置，将8条人类供体下肢在膝关节屈曲0°、30°和60°时进行定位并进行立体放射摄影记录，同时对足部施加4 Nm的内旋力。研究完整韧带膝关节的前后和旋转松弛度，并与连续切除和重建ACL及ALL后观察到的情况进行比较。
在ACL损伤的膝关节中切断ALL后，在所有三个膝关节屈曲角度，即0°（p = 0.04）、30°（p = 0.03）和60°（p < 0.01）时，内旋分别增加了1.0°、1.6°和2.5°。然而，在ACL重建的膝关节中重建ALL后，未发现松弛度降低。
ALL被确认为ACL损伤膝关节内旋的稳定器。然而，使用股薄肌自体移植肌腱重建ALL并未降低ACL重建膝关节的内旋松弛度。基于本研究结果，我们不建议在ACL重建的膝关节中重建ALL以降低膝关节内旋松弛度。
