Deichsel Adrian, Briese Thorben, Liu Wenke, Raschke Michael J, Albert Alina, Peez Christian, Herbst Elmar, Kittl Christoph
Department of Trauma, Hand and Reconstructive Surgery University Hospital Münster Münster Germany.
J Exp Orthop. 2025 Feb 17;12(1):e70174. doi: 10.1002/jeo2.70174. eCollection 2025 Jan.
The purpose of this study was to determine the role of different fibre areas of the tibial footprint of the posterior cruciate ligament (PCL) in restraining posterior tibial translation.
A sequential cutting study on cadaveric knee specimens ( = 8) was performed, utilizing a six-degrees-of-freedom robotic test setup. The tibial attachment of the PCL was divided into nine areas, which were sequentially cut in a randomized sequence. After determining the native knee kinematics with 89 N anterior, and posterior tibial translation force at 0°, 30°, 60° and 90° knee flexion, a displacement-controlled protocol was performed replaying the native motion. Utilizing the principle of superposition, the reduction of the restraining force represents the contribution (in-situ forces) of each cut fibre area.
The PCL was found to contribute 25.3 ± 11.1% in 0° of flexion, 49.7 ± 19.2% in 30° of flexion, 58.9 ± 19.3% in 60° of flexion and 50.6 ± 15.1% in 90° of flexion, to the restriction of a posterior drawer force. Depending on the flexion angle, every cut area of the tibial PCL footprint was shown to be a significant restrictor of posterior tibial translation ( ≤ 0.05). When investigating the fibre areas from anterior to posterior, the central fibre areas showed the highest contribution (35.0%-44.3%). When investigating the fibre areas from medial to lateral, the lateral fibre areas showed the highest contribution (41.4%-43.6%) from 0 to 30° knee flexion, while the medial fibre areas showed the highest contribution (41.5%) in 90° knee flexion.
The central row areas in the tibial footprint of the PCL were identified to be the main contributors inside the tibial footprint, while, depending on the flexion angle, the medial or lateral column fibre areas showed a higher contribution. These findings might inform the clinician to place a PCL graft centrally into the tibial footprint during reconstruction.
Not applicable.
本研究旨在确定后交叉韧带（PCL）胫骨止点不同纤维区域在限制胫骨后移中的作用。
利用六自由度机器人测试装置对8具尸体膝关节标本进行了顺序切割研究。PCL的胫骨附着点被分为9个区域，并按随机顺序依次切割。在用89N的前向和后向胫骨平移力在膝关节屈曲0°、30°、60°和90°时确定了正常膝关节运动学后，执行了位移控制方案以重现正常运动。利用叠加原理，约束力的降低代表每个切割纤维区域的贡献（原位力）。
发现PCL在膝关节屈曲0°时对后抽屉力的限制贡献为25.3±11.1%，在30°时为49.7±19.2%，在60°时为58.9±19.3%，在90°时为50.6±15.1%。根据屈曲角度，PCL胫骨止点的每个切割区域均显示为胫骨后移的显著限制因素（P≤0.05）。从前向后研究纤维区域时，中央纤维区域贡献最高（35.0%-44.3%）。从内侧向外侧研究纤维区域时，外侧纤维区域在膝关节屈曲0°至30°时贡献最高（41.4%-43.6%），而内侧纤维区域在膝关节屈曲90°时贡献最高（41.5%）。
PCL胫骨止点的中央排区域被确定为胫骨止点内的主要贡献区域，而根据屈曲角度，内侧或外侧柱纤维区域贡献更高。这些发现可能会告知临床医生在重建过程中将PCL移植物置于胫骨止点中央。
不适用。
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