Pache Santiago, Aman Zachary S, Kennedy Mitchell, Nakama Gilberto Yoshinobu, Moatshe Gilbert, Ziegler Connor, LaPrade Robert F
Steadman Philippon Research Institute, The Steadman Clinic, Vail, Colorado, USA.
Arch Bone Jt Surg. 2018 Jan;6(1):8-18.
The posterior cruciate ligament (PCL) is the largest and strongest ligament in the human knee, and the primary posterior stabilizer. Recent anatomy and biomechanical studies have provided an improved understanding of PCL function. PCL injuries are typically combined with other ligamentous, meniscal and chondral injuries. Stress radiography has become an important and validated objective measure in surgical decision making and post-operative assessment. Isolated grade I or II PCL injuries can usually be treated non-operatively. However, when acute grade III PCL ruptures occur together with other ligamentous injury and/or repairable meniscal body/root tears, surgery is indicated. Anatomic single-bundle PCL reconstruction (SB-PCLR) typically restores the larger anterolateral bundle (ALB) and represents the most commonly performed procedure. Unfortunately, residual posterior and rotational tibial instability after SB-PCLR has led to the development of an anatomic double-bundle (DB) PCLR to restore the native PCL footprint and co-dominant behavior of the anterolateral and posteromedial bundles and re-establish normal knee kinematics. The purpose of this article is to review the pertinent details regarding PCL anatomy, biomechanics, injury diagnosis and treatment options, with a focus on arthroscopically assisted DB-PCLR. IV.
后交叉韧带（PCL）是人体膝关节中最大且最强壮的韧带，也是主要的后向稳定结构。最近的解剖学和生物力学研究增进了人们对PCL功能的理解。PCL损伤通常合并有其他韧带、半月板和软骨损伤。应力放射成像已成为手术决策和术后评估中一项重要且经过验证的客观测量方法。孤立的I级或II级PCL损伤通常可采用非手术治疗。然而，当急性III级PCL断裂与其他韧带损伤和/或可修复的半月板体部/根部撕裂同时发生时，则需进行手术治疗。解剖单束PCL重建术（SB-PCLR）通常可恢复较大的前外侧束（ALB），是最常施行的手术。不幸的是，SB-PCLR术后残留的后向和胫骨旋转不稳促使了解剖双束（DB）PCLR的发展，以恢复天然PCL附着点以及前外侧束和后内侧束的共同主导作用，并重建正常的膝关节运动学。本文旨在回顾有关PCL解剖学、生物力学、损伤诊断和治疗选择的相关细节，重点是关节镜辅助下的DB-PCLR。四、
