Samuelson T S, Drez D, Maletis G B
Louisiana State University Knee and Sports Medicine Fellowship, Lake Charles.
Am J Sports Med. 1996 Jan-Feb;24(1):67-71. doi: 10.1177/036354659602400112.
The purpose of this study was to determine normal rotation of the anterior cruciate ligament and to provide a technique for reproduction of this rotation. Ten fresh-frozen knees were dissected of all soft tissue except for the anterior cruciate ligament. Specimens were secured in a vise in 60 degrees of flexion. Each tibia was allowed to spin freely on the femur, and rotation was recorded. Anterior cruciate ligament reconstructions, using bone-patellar tendon-bone grafts, were then performed on all specimens using four graft rotations. Each specimen was then tested to assess how the graft twist affected tibial rotation. The average tibial rotation of the normal anterior cruciate ligaments was 55 degrees internally. Previous descriptions of anterior cruciate ligament reconstructions have advocated medial or internal rotation of the graft to reproduce normal anatomic rotation of the anterior cruciate ligament. Our cadaveric dissections have demonstrated that the anterior cruciate ligament normally produces internal rotation of the tibia in relation to the femur. Reproduction of this anatomic rotation is accomplished with 90 degrees of lateral rotation of the tibial plug toward the fibula.
本研究的目的是确定前交叉韧带的正常旋转情况，并提供一种重现这种旋转的技术。对10个新鲜冷冻膝关节进行解剖，去除除前交叉韧带外的所有软组织。将标本固定在虎钳中，保持60度屈曲。让每个胫骨在股骨上自由旋转，并记录旋转情况。然后使用四种移植物旋转方式，对所有标本进行前交叉韧带重建，采用骨-髌腱-骨移植物。随后对每个标本进行测试，以评估移植物扭转如何影响胫骨旋转。正常前交叉韧带的平均胫骨内旋角度为55度。先前关于前交叉韧带重建的描述主张移植物进行内侧或内旋，以重现前交叉韧带的正常解剖旋转。我们的尸体解剖表明，前交叉韧带通常会使胫骨相对于股骨产生内旋。通过将胫骨骨块向腓骨方向外侧旋转90度可实现这种解剖旋转的重现。
