前交叉韧带胫骨棘止点的形态学特征及其生物力学特性研究

Anatomical observation and biomechanical studies of the anterior cruciate ligament and its attachment to the intercondylar tibial eminence

目的:研究前交叉韧带及其胫骨棘止点处的形态特征及其抗拉伸性能,为前交叉韧带胫骨棘撕脱骨折的临床治疗提供解剖和生物力学依据。方法:取正常成人新鲜的膝关节标本16例,游离出前交叉韧带,对其胫骨棘止点处的厚度、宽度及其在胫骨棘止点处的分布特点等进行观察。新鲜的标本通过MTS-858材料试验机测试前交叉韧带附着端的抗拉伸性能。结果:前交叉韧带呈水平位附着于胫骨棘及其周围的骨面,其断面近似于三角形,底朝前,尖向后方。部分纤维附着于外侧半月板的前、后角及内侧半月板前方的骨面。附着端横径为(11.3±1.4)mm、前后长径为(17.6±2.6)mm、周径为(49.2±6.1)mm、前缘距胫骨平台前缘为(11.5±2.6)mm、后缘距后交叉韧带胫骨附着区的前缘为(14.1±1.7)mm、计算附着面积为(96.6±8.3)mm2。前交叉韧带的最大载荷为(2546±89)N,最大变形量为(4.3±0.5)mm。结论:前交叉韧带的纤维分布及其胫骨棘止点处的形态特征以及生物力学特性与临床上撕脱骨折的治疗有很大的关联性。

Objective： To provide anatomy and biomechanical basis for the clinical therapy of fracture of the tibial spine by observing the anatomical parameters and the anti-stretch property of the anterior cruciate ligament （ACL）and its attachment to the intercondylar tibial eminence. Methods： 16 fresh cadaver knee joints were used. To observe ACL and its attachment to the intercondylar tibial eminence, the length, the thickness and the width were measured. The flesh cadaver knee joints were used to test the anti-stretch property on a material testing machine （MTS 858 Bionix test system, USA）. Result. ACL lies on the intercondylar tibial eminence and its width bone bed with a horizontal position, the transverse section of which almost like a triangular.The width of the attachment of ACL was （11.3±1.4）mm,the anteroposterior diameter of which was （17.6±2.6）mm and the length of the peripheral zone was （ 49.2±6. 1）mm.The length between anterior margin of the attachment of ACL and the anterior margin of tibia was （11.5±2.6）mm and the length between posterior margin of the attachment of ACL and the anterior margin was （14.1 ±1.7）mm.Counting the area of the attachment of ACL was （96.6 ±8.3）mm2.The average of the max-load of the attachment of ACL to the intercondylar tibial eminence was （2546 ±89）N,and the average of the max-deformation was （4.3 ±0.5）mm. Conclusions： There was great relativity between the fracture of the tibial spine and the anatomical parameters of the attachment of ACL to the intercondylar tibial eminence and its distribution of the ligament fiber.