Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Knee Surg Sports Traumatol Arthrosc. 2018 Feb;26(2):485-490. doi: 10.1007/s00167-017-4607-6. Epub 2017 Jun 24.
To clarify the morphology of anterior cruciate ligament (ACL) tibial insertion site in healthy young knees using high-resolution 3-T MRI.
Subjects were 50 ACL-reconstructed patients with a mean age of 21.4 ± 6.8 years. The contralateral healthy knees were scanned using high-resolution 3-T MRI. The tibial insertion sites of the anteromedial (AM) and posterolateral (PL) bundle fibres, and the ACL attachment on the anterior horn of lateral meniscus (AHLM) were segmented from the MR images, and 3D models were reconstructed to evaluate the morphology. The shape of ACL footprint was qualitatively analysed, and the size of AM and PL attachments and AHLM overlapped area was measured digitally.
Tibial AM and PL bundles were clearly identified in 42 of 50 knees (84.0%). Morphology of the whole ACL tibial insertion site was elliptical in 23 knees (54.8%) and triangular in 19 knees (45.2%), but not classified as C-shape in any knees. However, the AM bundle attachment was of C-shape in 29 knees (69.0%) and band-like in 13 knees (31.0%). Overlap of ACL on AHLM was found in 26 knees (61.9%), and the size of the overlapped area was 4.8 ± 4.7% of the whole ACL insertion site.
3D morphology of the intact ACL tibial insertion site analysed by high-resolution 3-T MRI was elliptical or triangular in healthy young knees. However, the AM bundle insertion site was of C-shape or band-like. A small lateral portion of the ACL was overlapped with the AHLM. As for clinical relevance, these findings should be considered in order to reproduce the native ACL insertion site sufficiently.
III.
使用高分辨率 3-T MRI 阐明健康年轻膝关节前交叉韧带（ACL）胫骨止点的形态。
本研究纳入了 50 例 ACL 重建患者，平均年龄为 21.4±6.8 岁。对其对侧健康膝关节进行高分辨率 3-T MRI 扫描。从 MRI 图像中对前内束（AM）和后外束（PL）纤维的胫骨止点以及 ACL 附着于外侧半月板前角（AHLM）的部位进行分割，并重建 3D 模型以评估形态。定性分析 ACL 足印的形状，并对 AM 和 PL 附着部以及 AHLM 重叠区域的大小进行数字化测量。
在 50 例膝关节中，42 例（84.0%）可清晰识别出胫骨 AM 和 PL 束。23 例（54.8%）整个 ACL 胫骨止点的形态为椭圆形，19 例（45.2%）为三角形，但没有膝关节呈 C 形。然而，29 例（69.0%）AM 束附着部呈 C 形，13 例（31.0%）呈带状。26 例（61.9%）在 AHLM 上发现 ACL 重叠，重叠面积占整个 ACL 止点的 4.8±4.7%。
高分辨率 3-T MRI 分析健康年轻膝关节完整 ACL 胫骨止点的 3D 形态为椭圆形或三角形。然而，AM 束附着部呈 C 形或带状。ACL 的一小部分外侧与 AHLM 重叠。就临床相关性而言，为了充分重现 ACL 胫骨止点，这些发现应该被考虑。
III 级。
