Ritchie J R, Bergfeld J A, Kambic H, Manning T
Cleveland Clinic Foundation, Ohio, USA.
Am J Sports Med. 1998 May-Jun;26(3):389-94. doi: 10.1177/03635465980260030801.
This study was undertaken to determine the contribution of various structures in the posterior cruciate ligament-deficient knee in resisting posterior tibial translation. With "isolated" injuries to the posterior cruciate ligament, the amount of posterior translation will decrease with the posterior drawer test as the knee is taken from neutral to internal tibial rotation. The present study was performed to conclusively determine the anatomic structure responsible for this clinical observation. The TestStar device was used to perform single-plane posterior drawer tests in 14 cadaveric knee specimens. The tests were performed with the knee in neutral tibial rotation and in 20 degrees of internal tibial rotation. The intact knee was tested and then the knee was tested after sequential sectioning of the meniscofemoral ligaments, the posterior cruciate ligament, the posteromedial capsule, and the superficial medial collateral ligament. With the knee in neutral rotation, posterior translation continued to increase as each structure was sectioned. With the knee in internal tibial rotation, posterior displacement was significantly less than in neutral rotation for each state until the superficial medial collateral ligament was sectioned; posterior translation was increased after its sectioning. Our data demonstrate that the superficial medial collateral ligament is the structure responsible for a decrease in posterior tibial translation in the posterior cruciate ligament-deficient knee.
本研究旨在确定后交叉韧带损伤膝关节中各种结构在抵抗胫骨后移方面的作用。对于后交叉韧带“孤立”损伤，当膝关节从中立位转为胫骨内旋时，后抽屉试验中后移量会随着膝关节的转动而减少。本研究旨在最终确定导致这一临床观察结果的解剖结构。使用TestStar装置对14个尸体膝关节标本进行单平面后抽屉试验。试验在胫骨中立旋转位和胫骨内旋20°时进行。先对完整膝关节进行测试，然后在依次切断半月板股骨韧带、后交叉韧带、后内侧关节囊和浅层内侧副韧带后对膝关节进行测试。在胫骨中立旋转位时，随着每个结构被切断，后移量持续增加。在胫骨内旋位时，在切断浅层内侧副韧带之前，每种状态下的后移明显小于中立旋转位；切断浅层内侧副韧带后后移增加。我们的数据表明，浅层内侧副韧带是导致后交叉韧带损伤膝关节中胫骨后移减少的结构。
