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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >The Complimentary Contributions of the Anterolateral Ligament and the Lateral Meniscus to the Control of Rotational Knee Laxity
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The Complimentary Contributions of the Anterolateral Ligament and the Lateral Meniscus to the Control of Rotational Knee Laxity

机译：前外侧韧带和外侧半月板对控制旋转膝关节松弛的贡献

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Objectives: Anatomical studies consistently describe an anatomical connection between the anterolateral ligament (ALL) and the lateral meniscus. The aim of this study was to investigate the role of the ALL and lateral meniscal posterior root (LMPR) in internal rotational (IR) control in the ACL deficient knee. Methods: Sixteen cadaveric knees were potted into a hip simulator proximally and a six degree of freedom load cell distally. Positional data for femur and tibia were collected using a navigation system. Testing was performed in 15° increments from extension to 90° of flexion under a 5 Nm internal rotational torque. Specimens were tested in the intact state and after division of the ACL (ACL-), before randomization to division of the ALL (ALL-/M+) or LMPR (ALL+/M-), and finally after division of the remaining structure (ALL-/LMPR-). A one-way ANOVA was performed for each sectioning condition at each knee flexion angle (α = 0.05). Results: In extension, there was no significant increase in IR after division of the ACL. After division of the LMPR, there was a significant increase in IR compared to the intact state of 2.93° (p<0.05). Division of the ALL caused only a small increase in IR compared to the intact state (0.87°, NS). Division of the ALL after the LMPR caused no additional increase in IR. At 30° flexion, division of the ALL caused a greater magnitude increase in IR when compared to the intact state than division of the LMPR (4.04° vs 1.32°), although neither reached statistical significance. At 45° flexion, division of the ALL increased IR compared to the intact state by 10.92° (p<0.05), whilst IR caused by division of the PRLM did not reach significance. This pattern of ALL dominance was maintained at 60° and 75° of knee flexion, where the increase in IR was significant compared to both the intact and ACL deficient states. Discussion: The ALL and LMPR demonstrate complimentary roles in the control of internal rotation, with the meniscal root more important near extension and the ALL beyond 30° of flexion. These results do not support anatomical ALL reconstruction for control of the pivot shift. LMPR repair may improve stability and have benefits for chondroprotection.
机译：目的：解剖学研究一致地描述了前外侧韧带（ALL）和外侧半月板之间的解剖联系。这项研究的目的是调查ALL和半月板后根（LMPR）在ACL缺陷膝关节内部旋转（IR）控制中的作用。方法：将十六具尸体膝盖向近端装入髋关节模拟器，并向远端装入六自由度测力传感器。使用导航系统收集股骨和胫骨的位置数据。在5 Nm的内部旋转扭矩下，从伸展到弯曲的90°以15°的增量进行测试。在完整状态下以及在ACL划分后（ACL-），随机分配到ALL（ALL- / M +）或LMPR（ALL + / M-）划分，最后是其余结构（ALL -/ LMPR-）。在每个膝盖屈曲角度（α= 0.05）下，对每种切片情况进行单向方差分析。结果：从总体上看，ACL分割后IR没有明显增加。 LMPR分割后，与完整状态的2.93°相比，IR明显增加（p <0.05）。与完整状态（0.87°，NS）相比，ALL的分裂仅引起IR的少量增加。 LMPR之后对ALL的划分并未导致IR的增加。在30°屈曲时，与完整状态相比，ALL的分裂引起的IR的增加幅度大于LMPR的分裂（4.04°对1.32°），尽管两者均未达到统计学意义。在45°屈曲时，与完整状态相比，ALL的IR增加了10.92°（p <0.05），而PRLM分开引起的IR没有达到显着性。 ALL优势的这种模式保持在膝盖弯曲的60°和75°，与完整状态和ACL缺乏状态相比，IR的增加是显着的。讨论：ALL和LMPR在控制内旋中显示出互补的作用，其中半月板根在伸展时更重要，而ALL在屈曲30°以上时更重要。这些结果不支持用于控制枢轴移位的解剖结构ALL重建。 LMPR修复可能会提高稳定性，并有益于软骨保护。

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