前交叉韧带中前内束与后外束功能上的差异研究  

Differences of the function between the anteromedial bundle and posterolateral bundle of the anterior cruciate ligament

作　　者：田鑫铎[1] 尹文哲[1] 孙敏[1] 叶义杰[1] 江磊磊[1] 任聪[1] 

机构地区：[1]哈尔滨医科大学附属第二医院骨外四科,黑龙江150081

出　　处：《创伤外科杂志》2013年第1期53-56,共4页Journal of Traumatic Surgery

摘　　要：目的研究前交叉韧带(ACL)中前内束(AMB)与后外束(PLB)在维持膝关节稳定性方面所起的不同作用。方法对12具新鲜冰冻尸体的膝关节标本在分别屈曲0°、15°、30°、60°及90°下对胫骨施加100N的前负荷及在0°、15°、30°下5Nm的胫骨内旋负荷,使两束韧带拉伸并带动电阻应变片形变引起阻值改变,从而引起输出电压值的变化。结果在对胫骨施加100N前负荷的条件下,AMB在屈膝60°和90°时的原位拉力显著>屈膝0°和15°时(P<0.05);而PLB在屈膝0°和15°时的原位拉力显著>屈膝30°、60°和90°时(P<0.05);在屈膝0°和15°时PLB的原位拉力显著>AMB(P<0.05);而在屈膝30°、60°和90°时AMB的原位拉力显著>PLB(P<0.05)。在对胫骨施加5Nm内旋负荷时,在屈膝15°和30°时AMB的原位拉力显著>PLB(P<0.05);在膝关节完全伸直位时二者无统计学差异(P>0.05)。结论虽然在ACL的双束中AMB起主要作用,但PLB的辅助作用仍不可忽视,其体现在膝关节接近伸直位维持前向和内旋稳定性方面。Objective To study the role of the anteromedial bundle （AMB） and posterolateral bundle （ PLB） of the anterior cruciate ligament（ACL） in maintaining knee joint stability. Methods In this study, 12 fresh-frozen human cadaveric knees were tested under two kinds of external loading conditions including a 100N anterior tibial load with the knee at 0°, 15° ,30° ,60°and 90°of flexion ; and a 5Nm pronation load with the knee at 0° , 15°and 30°of flexion. The two bunches of ligament were pulled tight that led the strain gauge to deformation, and changed output voltage value. Results In response to a 100N anterior tibial load, the situ force in the AMB was significantly greater at 60°and 90°than at full extension and 15°of flexion （ P 〈 0.05） ;the situ force in the PLB was significantly greater at full extension and 15 o than at 30°,60° and 90° of flexion（ P 〈 0.05 ） ; the situ force in the PLB was significantly greater than the AMB at full extension and 15° ; the situ force in the AMB was significantly greater than the PLB at 30° ,60° and 90°. In response to a 5Nm interned tibial torques load,the situ force in the AMB was significantly greater than the PLB at 15° and 30° of flexion （ P 〈 0.05 ） ; no statistical difference occurred between AMB and PLB at full extension （ P 〉 0.05 ）. Conclusion Though the AMB plays an important role in the ACL, the role of PLB should not be ignored in maintaining anterior and internal rotational stability at low flexion angles.

关 键 词：前交叉韧带 前内束 后外束 应变计 原位拉力 

分 类 号：R684[医药卫生—骨科学]