后交叉韧带损伤治疗的转化研究：从基础解剖学与生物力学研究到经过验证的手术结果
简介
该文总结了一项历时约20年的PCL损伤从基础到临床的转化研究体系：通过尸体解剖量化PCL前外侧束与后内侧束及用于骨道定位的骨性标志，结合机器人生物力学测试明确双束的共同主导贡献、移植物最佳固定角度，以及后外侧角损伤和胫骨后倾角较平对稳定性的不利影响，并验证跪位PCL应力X线片和MRI胫骨后移等客观诊断方法。基于上述结果形成的解剖型双束重建，辅以多韧带骨道会聚…
英文摘要
Posterior cruciate ligament (PCL) injuries were historically managed nonsurgically or with primary repairs, owing to limited anatomic knowledge, subjective diagnostic techniques, and nonvalidated reconstructions that frequently failed. We describe a two-decade, bench-to-bedside PCL research pyramid that progressively addressed these deficiencies. Foundational cadaveric work characterized the quantitative anatomy of the PCL, including the anterolateral and posteromedial bundles, yielding reproducible femoral and tibial osseous landmarks for tunnel placement. Robotic biomechanical testing established the codominant contribution of both bundles, optimal graft fixation angles, and the destabilizing influence of posterolateral corner injuries and flat tibial slope. Objective diagnostic methods, such as kneeling PCL stress radiography and posterior tibial translation on MRI, were validated to quantify laxity and detect chronic tears. These insights informed an anatomically grounded double-bundle reconstruction, complemented by multiligament tunnel convergence-avoidance strategies, evidence-based tensioning sequences, and a refined rehabilitation and bracing treatment protocol. Prospective outcome studies confirmed restoration of stability comparable to anterior cruciate ligament reconstructions, demonstrating how integrated translational research transformed treatment of this challenging injury.