Kaneda Y, Moriya H, Takahashi K, Shimada Y, Tamaki T
Department of Orthopaedic Surgery, School of Medicine, Chiba University, Japan.
Am J Sports Med. 1997 Nov-Dec;25(6):796-800. doi: 10.1177/036354659702500611.
Using biplanar roentgenographic photogrammetry, we investigated posterolateral rotatory instability of the knee joint both before and after sectioning of posterolateral structures, the posterior cruciate ligament, and the lateral collateral ligament. Fifteen fresh-frozen cadaveric knees were used. Compared with the intact state, sectioning of the posterior cruciate ligament alone did not increase the amount of external tibial rotation, but the axis of external tibial rotation shifted when the anterolateral bundle of the posterior cruciate ligament was cut. When the posterior cruciate ligament was cut after sectioning of the posterolateral structures and the lateral collateral ligament, external tibial rotation increased and the axis of external rotation shifted. The results demonstrated that sectioning of the anterolateral bundle of the posterior cruciate ligament is associated with a change in the location of the axis of tibial rotation. Therefore an isolated posterior cruciate ligament injury can alter the kinematics of the knee joint by changing the axis of external tibial rotation. The present results also demonstrate that the posterior cruciate ligament serves as a kind of secondary restraint to posterolateral rotatory instability in knees with injured posterolateral structures. Helical motion analysis using biplanar roentgenographic photogrammetry is a useful method for evaluating knee kinematics.
我们使用双平面X线摄影测量法，在切断后外侧结构、后交叉韧带和外侧副韧带之前和之后，研究膝关节后外侧旋转不稳定情况。使用了15个新鲜冷冻的尸体膝关节。与完整状态相比，单独切断后交叉韧带并未增加胫骨外旋量，但切断后交叉韧带前外侧束时，胫骨外旋轴发生了移位。在后外侧结构和外侧副韧带切断后再切断后交叉韧带，胫骨外旋增加且外旋轴移位。结果表明，切断后交叉韧带前外侧束与胫骨旋转轴位置的改变有关。因此，单纯的后交叉韧带损伤可通过改变胫骨外旋轴来改变膝关节的运动学。本研究结果还表明，后交叉韧带对后外侧结构损伤的膝关节后外侧旋转不稳定起到一种二级约束作用。使用双平面X线摄影测量法进行螺旋运动分析是评估膝关节运动学的一种有用方法。
