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中华关节外科杂志(电子版)

中华关节外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 605 -610. doi: 10.3877/cma.j.issn.1674-134X.2022.05.012

综述

前交叉韧带胫骨止点大体及影像学解剖研究进展
李铭1, 孟繁钢1, 何爱珊1,†()   
  1. 1. 510080　广州，中山大学附属第一医院运动医学科
  • 收稿日期:2021-12-23 出版日期:2022-10-01
  • 通信作者: 何爱珊

Research advances in general and imaging anatomy of tibial insertion of anterior cruciate ligament

Ming Li1, Fangang Meng1, Aishan He1,†()   

  1. 1. Department of Sports Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  • Received:2021-12-23 Published:2022-10-01
  • Corresponding author: Aishan He
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李铭, 孟繁钢, 何爱珊. 前交叉韧带胫骨止点大体及影像学解剖研究进展[J]. 中华关节外科杂志(电子版), 2022, 16(05): 605-610.

Ming Li, Fangang Meng, Aishan He. Research advances in general and imaging anatomy of tibial insertion of anterior cruciate ligament[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2022, 16(05): 605-610.

无论是前交叉韧带单束重建还是双束重建，都对于解剖性重建有着很高的要求，而对前交叉韧带的解剖有一个清晰的认识是临床医生准确放置解剖位点的骨隧道的基础，因前交叉韧带股骨止点的解剖研究已较为深入，但对于胫骨止点的解剖研究，无论是大体或是影像学上的形态特征都还未能达成共识，本文则就前交叉韧带胫骨止点的解剖研究做一综述。

关键词: 前交叉韧带, 解剖学, 前交叉韧带重建

Both anterior cruciate ligament (ACL)single-bundle and double-bundle reconstructions have high requirements for anatomical reconstruction, while the clear understanding of the anatomy of the ACL is the foundation for clinicians to better place the bone tunnel at the anatomical site. Considering that the anatomy of the femoral insertion of the ACL has been studied in depth, however, no consensus has been reached on the anatomical study of the tibial stop, either in general anatomic or on the morphological features of the imaging. This article mainly reviewed the anatomy of the tibial insertion of the ACL

Key words: Anterior cruciate ligament, Anatomy, Anterior cruciate ligament reconstruction
图1 SIA(矢状面倾斜角)测量示意图
[17]
Siegel L, Vandenakker-Albanese C, Siegel D. Anterior cruciate ligament injuries: anatomy, physiology, biomechanics, and management[J]. Clin J Sport Med, 2012, 22(4): 349-355.
[18]
Śmigielski R, Zdanowicz U, Drwięga M, et al. The anatomy of the anterior cruciate ligament and its relevance to the technique of reconstruction[J]. Bone Joint J, 2016, 98-b(8): 1020-1026.
[19]
Edwards A, Bull AM, Amis AA. The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament: Part 1: tibial attachment[J]. Knee Surg Sports Traumatol Arthrosc, 2007, 15(12): 1414-1421.
[20]
陈连旭，余家阔，敖英芳，等．前交叉韧带止点形态学测量及重建骨道直径探讨[J]．中国运动医学杂志，2011，30(5):432-436.
[21]
Guenther D, Irarrázaval S, Nishizawa Y, et al. Variation in the shape of the tibial insertion site of the anterior cruciate ligament: classification is required[J]. Knee Surg Sports Traumatol Arthrosc, 2017, 25(8): 2428-2432.
[22]
Siebold R, Schuhmacher P, Fernandez F, et al. Flat midsubstance of the anterior cruciate ligament with tibial " C" -shaped insertion site[J]. Knee Surg Sports Traumatol Arthrosc, 2015, 23(11): 3136-3142.
[23]
Dargel J, Pohl P, Tzikaras P, et al. Morphometric side-to-side differences in human cruciate ligament insertions[J]. Surg Radiol Anat, 2006, 28(4): 398-402.
[24]
Purnell ML, Larson A, Clancy W. Anterior cruciate ligament insertions on the tibia and femur and their relationships to critical bony landmarks using high-resolution volume-rendering computed tomography[J]. Am J Sports Med, 2008, 36(11): 2083-2090.
[25]
Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis[J]. Clin Orthop Relat Res, 1975(106): 216-231.
[26]
Siebold R, Ellert T, Metz S, et al. Tibial insertions of the anteromedial and posterolateral bundles of the anterior cruciate ligament: morphometry, arthroscopic landmarks, and orientation model for bone tunnel placement[J]. Arthroscopy, 2008, 24(2): 154-161.
[27]
Luites JW, Wymenga AB, Blankevoort L, et al. Description of the attachment geometry of the anteromedial and posterolateral bundles of the ACL from arthroscopic perspective for anatomical tunnel placement[J]. Knee Surg Sports Traumatol Arthrosc, 2007, 15(12): 1422-1431.
[28]
Kopf S, Musahl V, Tashman S, et al. A systematic review of the femoral origin and tibial insertion morphology of the ACL[J]. Knee Surg Sports Traumatol Arthrosc, 2009, 17(3): 213-219.
[29]
张强，张春礼，徐虎，等．双源CT三维重建前交叉韧带胫骨止点印迹的临床研究[J]．中国微创外科杂志，2012，12(2):164-167.
[30]
Irarrázaval S, Albers M, Chao T, et al. Gross, arthroscopic, and radiographic anatomies of the anterior cruciate ligament: foundations for anterior cruciate ligament surgery[J]. Clin Sports Med, 2017, 36(1): 9-23.
[31]
Ziegler CG, Pietrini SD, Westerhaus BD, et al. Arthroscopically pertinent landmarks for tunnel positioning in single-bundle and double-bundle anterior cruciate ligament reconstructions[J]. Am J Sports Med, 2011, 39(4): 743-752.
[32]
Zantop T, Wellmann M, Fu FH, et al. Tunnel positioning of anteromedial and posterolateral bundles in anatomic anterior cruciate ligament reconstruction: anatomic and radiographic findings[J]. Am J Sports Med, 2008, 36(1): 65-72.
[33]
Hwang MD, Piefer JW, Lubowitz JH. Anterior cruciate ligament tibial footprint anatomy: systematic review of the 21st century literature[J]. Arthroscopy, 2012, 28(5): 728-734.
[34]
Iriuchishima T, Ingham SJ, Tajima G, et al. Evaluation of the tunnel placement in the anatomical double-bundle ACL reconstruction: a cadaver study[J]. Knee Surg Sports Traumatol Arthrosc, 2010, 18(9): 1226-1231.
[35]
Colombet P, Robinson J, Christel P, et al. Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study[J]. Arthroscopy, 2006, 22(9): 984-992.
[36]
Hutchinson MR, Bae TS. Reproducibility of anatomic tibial landmarks for anterior cruciate ligament reconstructions[J]. Am J Sports Med, 2001, 29(6): 777-780.
[37]
Howell SM. Principles for placing the tibial tunnel and avoiding roof impingement during reconstruction of a torn anterior cruciate ligament[J]. Knee Surg Sports Traumatol Arthrosc, 1998, 6 (Suppl 1): S49-S55.
[38]
Tung GA, Davis LM, Wiggins ME, et al. Tears of the anterior cruciate ligament: primary and secondary signs at Mr imaging[J]. Radiology, 1993, 188(3): 661-667.
[39]
Frank RM, Seroyer ST, Lewis PB, et al. MRI analysis of tibial position of the anterior cruciate ligament[J]. Knee Surg Sports Traumatol Arthrosc, 2010, 18(11): 1607-1611.
[40]
Swami VG, Mabee M, Hui C, et al. MRI anatomy of the tibial ACL attachment and proximal epiphysis in a large population of skeletally immature knees: reference parameters for planning anatomic physeal-sparing ACL reconstruction[J]. Am J Sports Med, 2014, 42(7): 1644-1651.
[41]
Konarski A, Strang M, Jain N. The natural orientation of the anterior cruciate ligament compared to the tibial plateau on magnetic resonance imaging scans [J]. J Orthop, 2020, 22: 422-426.
[42]
丁杰．前交叉韧带胫骨止点的解剖学与影像学定位研究[D]．上海：上海体育学院，2015.
[43]
Reid JC, Yonke B, Tompkins M. The angle of inclination of the native ACL in the coronal and sagittal planes[J]. Knee Surg Sports Traumatol Arthrosc, 2017, 25(4): 1101-1105.
[44]
Illingworth KD, Hensler D, Working ZM, et al. A simple evaluation of anterior cruciate ligament femoral tunnel position: the inclination angle and femoral tunnel angle[J]. Am J Sports Med, 2011, 39(12): 2611-2618.
[45]
Hagiwara K, Terauchi M, Hatayama K, et al. Sagittal inclination angle of graft is associated with knee stability after anatomic anterior cruciate ligament reconstruction[J]. Arthroscopy, 2021, 37(8): 2533-2541.
[46]
Kyung BS, Kim JG, Chang M, et al. Anatomic double-bundle Reconstruction techniques result in graft obliquities that closely mimic the native anterior cruciate ligament anatomy[J]. Am J Sports Med, 2013, 41(6): 1302-1309.
[47]
Gobbi RG, Videira LD, Dos Santos AA, et al. Anatomical risk factors for anterior cruciate ligament injury are not important as patellar instability risk factors in patients with acute knee injury[J]. J Knee Surg, 2022, 35(6): 676-683.
[48]
Hashemi J, Chandrashekar N, Mansouri H, et al. Shallow medial tibial plateau and steep medial and lateral tibial slopes: new risk factors for anterior cruciate ligament injuries[J]. Am J Sports Med, 2010, 38(1): 54-62.
[49]
Wordeman SC, Quatman CE, Kaeding CC, et al. In vivo evidence for tibial plateau slope as a risk factor for anterior cruciate ligament injury: a systematic review and meta-analysis[J]. Am J Sports Med, 2012, 40(7): 1673-1681.
[50]
Christensen JJ, Krych AJ, Wm E, et al. Lateral tibial posterior slope is increased in patients with early graft failure after anterior cruciate ligament reconstruction[J]. Am J Sports Med, 2015, 43(10): 2510-2514.
[51]
Hohmann E, Bryant A, Reaburn P, et al. Does posterior tibial slope influence knee functionality in the anterior cruciate ligament-deficient and anterior cruciate ligament-reconstructed knee？[J]. Arthroscopy, 2010, 26(11): 1496-1502.
[52]
Zampeli F, Ntoulia A, Giotis D, et al. Correlation between anterior cruciate ligament graft obliquity and tibial rotation during dynamic pivoting activities in patients with anatomic anterior cruciate ligament reconstruction: an in vivo examination[J]. Arthroscopy, 2012, 28(2): 234-246.
[1]
Anderson MJ, Browning WM, Urband CE, et al. A systematic summary of systematic reviews on the topic of the anterior cruciate ligament[J/OL]. Orthop J Sports Med, 2016, 4(3): 2325967116634074. DOI：10.1177/2325967116634074.
[2]
Kaeding CC, Léger-St-Jean B, Magnussen RA. Epidemiology and diagnosis of anterior cruciate ligament injuries[J]. Clin Sports Med, 2017, 36(1): 1-8.
[3]
Wang LJ, Zeng N, Yan ZP, et al. Post-traumatic osteoarthritis following ACL injury[J]. Arthritis Res Ther, 2020, 22(1): 57-64.
[4]
Biau DJ, Tournoux C, Katsahian S, et al. ACL reconstruction: a meta-analysis of functional scores[J]. Clin Orthop Relat Res, 2007 458: 180-187.
[5]
Lidén M, Sernert N, Rostgård-Christensen L, et al. Osteoarthritic changes after anterior cruciate ligament Reconstruction using bone-patellar tendon-bone or hamstring tendon autografts: a retrospective, 7-year radiographic and clinical follow-up study[J]. Arthroscopy, 2008, 24(8): 899-908.
[6]
Pinczewski LA, Lyman J, Salmon LJ, et al. A 10-year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft: a controlled, prospective trial[J]. Am J Sports Med, 2007, 35(4): 564-574.
[7]
Meredick RB, Vance KJ, Appleby D, et al. Outcome of single-bundle versus double-bundle reconstruction of the anterior cruciate ligament: a meta-analysis[J]. Am J Sports Med, 2008, 36(7): 1414-1421.
[8]
Hensler D, Van Eck CF, Fu FH, et al. Anatomic anterior cruciate ligament reconstruction utilizing the double-bundle technique[J]. J Orthop Sports Phys Ther, 2012, 42(3): 184-195.
[9]
Kraeutler MJ, Welton KL, Mccarty EC, et al. Revision anterior cruciate ligament reconstruction[J]. J Bone Joint Surg Am, 2017, 99(19): 1689-1696.
[10]
张强，张春礼，徐虎，等．双源CT三维重建前交叉韧带股骨止点及隧道面积的临床研究[J/CD]．中华关节外科杂志(电子版)，2013，7(1):20-24.
[11]
罗浩，敖英芳，王海军，等．膝关节前交叉韧带前内束和后外束股骨止点位置的解剖研究[J/CD]．中华关节外科杂志(电子版)，2012，6(1):97-103.
[12]
Matava MJ, Arciero RA, Baumgarten KM, et al. Multirater agreement of the causes of anterior cruciate ligament reconstruction failure: a radiographic and video analysis of the Mars cohort[J]. Am J Sports Med, 2015, 43(2): 310-319.
[13]
王健全，敖英芳，刘平，等．前交叉韧带股骨止点临床解剖学研究[J]．中国运动医学杂志，2007，26(3):266-270.
[14]
Zauleck MK, Gabriel S, Fischmeister MF, et al. Origin of the anterior cruciate ligament and the surrounding osseous landmarks of the femur[J]. Clin Anat, 2014, 27(7): 1103-1110.
[15]
Oka S, Schuhmacher P, Brehmer A, et al. Histological analysis of the tibial anterior cruciate ligament insertion[J]. Knee Surg Sports Traumatol Arthrosc, 2016, 24(3): 747-753.
[16]
Moulton SG, Steineman BD, Haut DT, et al. Direct versus indirect ACL femoral attachment fibres and their implications on ACL graft placement[J]. Knee Surg Sports Traumatol Arthrosc, 2017, 25(1): 165-171.
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