Anatomical Observation And Clinical Research In Posterolateral Complex Of The Knee

Objective: Through the anatomical observation and measurement of posterolateralcomplex of the kneed(PCL), to provide anatomical basis for the PLC injury, and discussingthe surgical procedures and clinical effect of the PLC reestablishmentMethods: Dissecting14cases adult knee joint samples step by step, observing andmeasuring the possible structures of PLC. The PLC injury(10knee-joint) adopt fromFebruary,2012to September,2013, was isometric reconstructed PFL and LCL by theautotransplantation of semitendinosus tendons, and reestablishing the PLC. Comparing theknee joint extorsion experiment before and after surgery by Lysholm scale, and analyzingby pair T test.Results: The total length of LCL is (53.7±3.75)mm, the distance from the center of theproximal attachment points to the edge of the lateral condyle is (18.31±1.84)mm, and thedistance to the trailing edge of the lateral condyle is (20.26±3.65)mm, the verticaldimension from the distal attachment points to the apex capitis fibulae is (14.21±2.24)mm.PT the distance from the center of the proximal attachment points to the edge of the lateralcondyle is (12.97±1.13)mm, the distance to the lateral condyle posterior edge is(19.18±2.63)mm, located in the popliteus muscle-tendon migration about (8.78±0.53)mmto the tibia platform. Anterior edge of PFL is (10.76±2.01)mm, and the posterior edge is(6.93±1.13)mm. AL occurrence rate is100%, inside of the bow is (27.37±1.32)mm,and theoutside is (24.64±1.32)mm,lateral inferior genicular artery pass through under this. In thisexperiment, the FFL occurrence rate is35.7%(5/14), the overall length is(27.28±2.31).The10cases patients all have follow-up study, the time is6-24months, andthe average time is15months. All the patients’ knee pain, swell and abnormal gaitdisappear, no common peroneal nerve injury symptom occur after the surgery. Knee jointextending position has no varus instability. Bending patients’ knees for30°outward turningexperiment, rotation angle decrease in one case. The range of knee motion is115°-130°,and one patient has5°-10°limit extension of the knee joint, but the angle of bending kneeis normal.Conclusion: By this study we clearly understand the morphological feature of PLC, and know that it’s anatomical features have important meaning to the diagnosis and treatmentafter PLC injury. PLC locate in the most superficial layer of the posterolateral complex, it’sposition is stable and can be the anatomical marks in the surgery, and revealed the otherstructures behind and under it. Choose the anatomy end point as the locating point toproceed the bone tunnel reconstruction and to avoid the collapse of the bone tunnel, weshould strict control the size of the drills when building the tunnel. As the ligamentcontracture scars are sticky and hard to separate, and cause the ligament end point hard toidentify, you can consult the result of this experiment to find the bone tunnel locating point.Isometric reconstruct PFL and LCL by the autotransplantation of semitendinosus tendons,and reestablish the PLC, at the same time of effective knee stability recovery, it has theadvtaganes of high maneuverability and less trauma.