前交叉韧带方位角变化的解剖学测量研究

目的:探讨前交叉韧带(anterior cruciate ligament,ACL)在膝关节不同屈曲角度时的方位角变化,为ACL损伤诊断和重建研究提供解剖学支持。方法:成人膝关节标本10具,解剖观察ACL形态,用Photoshop软件测量膝关节不同屈曲角度下ACL方位角变化。结果:0°、30°位膝关节中ACL胫骨角大于ACL股骨角,有显著性差异(P0.01);60°、90°位膝关节中的ACL胫骨角小于股骨角,有显著性差异(P0.01)。膝关节0°、30°、60°、90°ACL胫骨角由大渐小,各角度间均有显著性差异(均P0.01)。膝关节0°和30°的ACL股骨角比60°和90°时小,有显著性差异(均P0.01),0°与30°间无显著性差异(P0.05),60°小于90°,有显著性差异(P0.01)。结论:ACL于膝关节0°和30°位时,后外侧束(posterolateral bundle,PLB)发挥主要作用,ACL诊断或重建主要参考胫骨角;60°、90°时ACL前内侧束(anteromedial bundle,AMB)发挥主要作用,ACL诊断或重建主要参考股骨角。ACL方位角可作为ACL损伤诊断和手术重建的重要参考。

Anatomical Study of the ACL Azimuth Angle Change

Objective:To investigate the azimuth angle change of anterior cruciate ligament (ACL) in different knee flexion Angleand to provide anatomical support for diagnosis and reconstruction of ACL injury research.Methods:The specimens in this experimentare 10 normal knee joints of adult. Measuring the ACL azimuth angle when the knee joint located at 0° , 30° , 60° , and 90°respectively.Results:When the knee locates at 0° and 30° , the included angle of ACL and medial meniscus is bigger than the includedangle of ACL and femur (P<0.01). When the knee locates at 60° and 90° , the included angle of ACL and medial meniscus is smallerthan the included angle of ACL and femur (P<0.01). The included angle of ACL and medial meniscus are ordered frombig to small withthe sequence as 0° , 30° , 60° , and 90° (P<0.01). The included angle of ACL and femur are ordered as 90° , 60° , 30° and 0° . Theangle at 0° and 30° has no significant difference (P>0.05).Conclusion:The PLB plays a major role when the knee is at 0° and 30° .In ACL diagnosis or reconstruction, the included angle of ACL and medial meniscus should be a main reference factors. The AMB play amajor role when the knee at 60° and 90° . In ACL diagnosis or reconstruction, the included angle of ACL and femur should be a mainreference factor.