后交叉韧带在损伤后膝关节中作用的生物力学研究

Biomechanical study of the role of posterior cruciate ligament on injured knee joint

目的：通过测试韧带切除对膝关节稳定性的影响，为后交叉韧带损伤的临床诊治提供实验依据。方法：采用１４例新鲜尸体膝关节，经三维运动试验机施加５种力偶，使膝关节产生三维运动。首先对完整标本进行测试，测得的结果为自身对照组，然后测试分别切除韧带后的三维变化。结果：经立体摄像机计算机图像处理得到正常膝关节的角位移运动范围为：前伸１８．３°±３．３°，外展３．４°±２．０°，内收４．８°±１．８°，外旋２３．９°±２．４°，内旋２６．６°±５．３°；单纯后交叉韧带切除后膝关节的角位移运动范围无限制性变化；继外侧副韧带切除后再行后交叉韧带切断时，膝关节的外展、内收运动出现限制性增大（Ｐ＜０．０５），而其旋转运动出现极显著性增大（Ｐ＜０．０１）。结论：后交叉韧带对稳定状态下的膝关节不影响其角运动。在膝关节处于不稳定状态时，后交叉韧带则具有限制内收、外展及旋转运动的作用。后交叉韧带不仅是胫骨后移的第一限制韧带，而且还是膝关节内收、外展及旋转的第二限制韧带。

Objective:To study the effect of posterior cruciate ligament (PCL)resection on knee joint stabilityMethods:The three-dimension motion of 14 fresh knee joint specimens was tested before and after the PCL was resectedResults:The motion of knee joint was not changed after the PCL resection,but it significantly increased after the PCL resection combined with lateral accessory ligament (LAL) resection (P<005)Conclusions:The pure PCL resection would not influence the stability of knee jointAnd the joint was unstable when both PCL and LAL were resected