The in vivo kinematics of the anteromedial and posterolateral bundles of the anterior cruciate ligament during weightbearing knee flexion
The in vivo kinematics of the anteromedial and posterolateral bundles of the anterior cruciate ligament during weightbearing knee flexion
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DOI：
10.1177/0363546506295941
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发表时间：
2007-04-01
影响因子：
4.8
通讯作者：
Li, Guoan
中科院分区：
文献类型：
--
作者：
Jordan, Susan S.;DeFrate, Louis E.;Li, Guoan
背景：最近，双束前交叉韧带重建术被提倡。然而，关于前交叉韧带前内侧束和后外侧束的体内生物力学数据很少。我们的目的是测量的运动学的2束在负重flexion.Study设计：描述性实验室study.Hypothesis：束的前交叉韧带是最长的低屈曲角度在体内负重flexion.Methods：磁共振图像从7名健康受试者被用来创建三维模型的膝盖。在每个模型上概述了前内侧和后外侧束的附件。接下来，受试者在使用双正交荧光透视系统成像的同时从完全伸展到1351进行准静态弓步。模型和透视图像用于再现膝关节的运动。测量了功能束的长度、高度、偏离和扭曲度。结果：前内侧和后外侧束在低屈曲角时最长，随着屈曲度的增加而明显缩短。在低屈曲角（< 45 °）时，两束的仰角和偏斜角相似。束的扭曲是最小的（< 5度）在低flexion.Conclusion：在体内屈曲，前内侧和后外侧束没有表现出在以前的尸体研究中指出的相互行为。两束平行，在低屈曲角时最大程度延长。我们的数据表明，如果进行双束重建，可能需要在股骨和胫骨钻2个隧道，以重现前交叉韧带的方向。前内侧和后外侧移植物均应在低屈曲角度下固定，以防止过度限制。
Background: Recently, double-bundle anterior cruciate ligament reconstruction has been advocated. However, there are little data on the in vivo biomechanics of the anteromedial and posterolateral bundles of the anterior cruciate ligament. Our objective was to measure the kinematics of the 2 bundles during weightbearing flexion.Study Design: Descriptive laboratory study.Hypothesis: The bundles of the anterior cruciate ligament are longest at low flexion angles during in vivo weightbearing flexion.Methods: Magnetic resonance images from 7 healthy subjects were used to create 3-dimensional models of the knee. The attachments of the anteromedial and posterolateral bundles were outlined on each model. Next, the subjects performed a quasi-static lunge from full extension to 1351 while being imaged using a dual orthogonal fluoroscopic system. The models and fluoroscopic images were used to reproduce the motion of the knee. The length, elevation, deviation, and twist of the functional bundles were measured.Results: The anteromedial and posterolateral bundles were longest at low flexion angles and shortened significantly with increasing flexion. The elevation and deviation angles of both bundles were similar at low flexion angles (< 45 degrees). The twist of the bundles was minimal (< 5 degrees) at low flexion.Conclusion: With in vivo flexion, the anteromedial and posterolateral bundles did not demonstrate the reciprocal behavior noted in previous cadaveric studies. Both bundles were parallel and maximally elongated at low flexion angles. Our data suggest that if a double-bundle reconstruction is performed, 2 tunnels might need to be drilled in the femur and tibia to reproduce the orientation of the anterior cruciate ligament. Both anteromedial and posterolateral grafts should be fixed at low flexion angles to prevent over-constraint.