Jenny Jean-Yves, Puliero Benjamin, Schockmel Gilles, Harnoist Sébastien, Clavert Philippe
Center for Orthopedic and Hand Surgery, CCOM, University Hospital Strasbourg, 10 avenue Baumann, 67400, Illkirch, France.
Institute of Normal Anatomy, University of Strasbourg, 1 place de l'Hôpital, 67000, Strasbourg, France.
Eur J Orthop Surg Traumatol. 2018 Jul;28(5):955-958. doi: 10.1007/s00590-017-2101-y. Epub 2017 Dec 5.
Knee laxity may be impacted by rupture of the anterolateral knee ligament (ALL). The goal of this study was to measure tibial translation and rotation as a function of the status of the ALL and the anterior cruciate ligament (ACL). Five pairs of fresh frozen cadaver specimens were analyzed. The knee was positioned in 20° flexion. Calibrated posteroanterior forces and internal/external torques were successively applied. Anterior tibial translation and total internal/external tibial rotation were measured with a navigation system. Three conditions were used in each knee: intact ACL and ALL, transection of ACL or ALL (randomly assigned to each knee of a pair), and transection of both ligaments. The primary outcome criterion was the increase in tibial rotation at 8 Nm. The mean increase in tibial rotation at 8 Nm was 0.8° after transecting the ALL only, 1.2° after transecting the ACL only, and 0.8° after transecting both ligaments. The mean increase in anterior tibial translation at 250 N was 1.2 mm after transecting the ALL only, 9.0 mm after transecting the ACL only, and 6.1 mm after transecting both ligaments. There was no significant increase in the tibial rotation or anterior tibial translation after transecting the ALL only or after transecting the ALL in ACL-deficient knees. The expected role of ALL in controlling anterior or rotational tibia motion could not be confirmed.
膝关节前外侧韧带(ALL)断裂可能会影响膝关节的松弛度。本研究的目的是测量胫骨平移和旋转,作为ALL和前交叉韧带(ACL)状态的函数。分析了五对新鲜冷冻尸体标本。膝关节处于20°屈曲位。依次施加校准的前后向力和内/外扭矩。使用导航系统测量胫骨前移和胫骨总内/外旋转。每个膝关节采用三种情况:ACL和ALL完整、ACL或ALL横断(随机分配到一对膝关节中的每个膝关节)以及两条韧带均横断。主要观察指标是8 Nm时胫骨旋转的增加。仅横断ALL后,8 Nm时胫骨旋转的平均增加为0.8°,仅横断ACL后为1.2°,两条韧带均横断后为0.8°。仅横断ALL后,250 N时胫骨前移的平均增加为1.2 mm,仅横断ACL后为9.0 mm,两条韧带均横断后为6.1 mm。仅横断ALL后或在ACL缺失的膝关节中横断ALL后,胫骨旋转或胫骨前移均无显著增加。ALL在控制胫骨前向或旋转运动中的预期作用无法得到证实。