后外侧角股骨止点与前交叉韧带解剖重建股骨隧道外口的关系

目的 测量后外侧角（PLC）股骨止点和前交叉韧带（ACL）解剖重建股骨隧道外口的位置，以获得详细的解剖学资料，并以此为ACL和PLC一期解剖重建提供解剖依据。 方法 采用30例新鲜成人尸体膝关节标本。屈膝120°关节镜下经前内辅助入路解剖重建ACL股骨隧道，并用克氏针标记。在膝关节股骨外髁分离出膝关节外侧副韧带（LCL）和腘肌腱(PT)股骨解剖止点。以股骨外上髁为原点，建立x、y垂直坐标轴，测量LCL、PT的股骨解剖中心点和ACL股骨隧道外口在坐标轴的坐标，并测量3点之间的距离。 结果 LCL附丽部中心点在股骨外上髁近端（1.27±3.35）mm，后方（2.99±1.29）mm。PT附丽部中心点在股骨外上髁远端（8.85±3.38）mm、后方（3.83±1.95）mm。ACL股骨隧道外口在股骨外上髁近端（16.12±5.34）mm，后方（6.84±4.17）mm。LCL附丽部中心点与PT附丽部中心点相距（9.67±3.92）mm，ACL股骨隧道外口与LCL附丽部中心点相距（13.07±4.93）mm，ACL股骨隧道外口与PT附丽部中心点相距（23.37±6.16）mm。 结论 揭示了LCL、PT的股骨解剖中心点和ACL股骨隧道外口位置的解剖学特点，为临床一期联合解剖重建提供解剖学依据。

Relationship between the posterior-lateral corner of femoral insertion and external opening of femoral tunnel used in reconstruction of the anterior cruciate ligament

Objective To locatize the positions of posterior-lateral corner(PLC) of femoral insertion and external opening of femoral tunnel used in reconstructure of the anterior cruciate ligament (ACL) in order to provide anatomical data for one-stage ACL and PCL anatomical reconstruction. Methods We used 30 adult cadaveric knee specimens. With flextion of knee at 120°, the anatomical ACL femoral tunnel reconstruction was performed under arthroscopy through anteromedial portal and marked with Kirschner. We identified femoral insertion site of the lateral collateral ligament(LCL) and popliteus tendon(PT) on the femoral condyle of the knee. We used the femoral epicondyle as the origin and established(x, y) vertical axis to measure the coordinate of femoral anatomical insertion site of LCL, PT and external opening of ACL femoral tunnel. We measured distances between these three points. Results The LCL insertion site was located at a mean distance of (1.27±3.35)mm proximally and (2.99±1.29)mm posteriorly, to the lateral epicondyle. The PT insertion site was located at a mean distance of (8.85±3.38)mm disstally and (3.83±1.95)mm posteriorly, to the lateral epicondyle. The external opening of the ACL femoral tunnel was located at a mean distance of (16.12±5.34)mm proximally and (6.84±4.17)mm posteriorly, to the lateral epicondyle. The distance between LCL and PT insertion site was (9.67±3.92)mm. The distance from the external opening of ACL femoral tunnel to LCL insertion site was (13.07±4.93)mm, and to PT insertion site was (23.37±6.16)mm. Conclusion We reveal anatomic characteristic of femoral insertion site of the LCL and PT and
external opening of ACL femoral tunnel, and provide anatomic basis for one-stage clinical combination reconstruction.