 引言Introduction 良好的膝关节功能对活动性至关重要，包括站立、行走和跑步。为了更好地理解膝盖问题是如何发生的，了解一些膝关节的解剖结构以及膝关节的各个部分是如何协同工作以维持正常功能是非常重要的。膝盖的重要结构可以分为几类。这些包括骨骼、关节、韧带、肌腱、肌肉、神经和血管。 A well function knee joint is critical to mobility including standing walking and running. To better understand how knee problems occur, it is important to understand some of the anatomy of the knee joint, and how the parts of the knee work together to maintain normal function. The important structures of the knee can be divided into several categories. These include bones, joints, ligaments, tendons, muscles, nerves and blood vessels. 常见解剖术语 Common anatomic terms 首先，让我们定义一些与膝盖有关的常见解剖术语，这样我们后面会讲到结构会更清楚。 身体的很多部位都有重复结构，所以，用术语来描述身体的各个部分是很常见的。 First, let's define some common anatomic terms as they relate to the knee. This will make it clearer as we talk about the structures later. Many parts of the body have duplicates, so it is common to describe parts of the body using terms. 这些术语定义了身体的各个部分与身体中间的假想线之间的关系 That define where the part is in relation to an imaginary line drawn through the middle of the body. 例如，中间的意思是更接近中线，所以，膝的内侧是离另一膝盖更近的一边，膝盖的外侧是远离另一膝关节的那一边。内侧的结构通常将内侧作为其名称的一部分，例如内侧半月板。“前” 指的是膝盖的前部，而 “后” 指的是膝盖的后部，因此前交叉韧带在后交叉韧带的前面。 For example, medial means closer to the midline, so the medial side of the knee is the side that is closest to the other knee, the lateral side of the knee is the side that is away from the other knee. Structures on the medial side usually have medial as part of their name, such as the medial meniscus. The term anterior refers to the front of the knee while the term posterior refers to the back of the knee. So the anterior cruciate ligament is in front of the posterior cruciate ligament. 骨 Bones 膝是股骨和胫骨与髌骨（或称膝盖骨，像通常所称呼的那样）组成的关节，髌骨由骨头构成 位于膝关节前面。膝关节是一个滑膜关节，滑膜关节被韧带囊包围，包含一种液体称为关节液用来润滑关节。 The knee is the joints where the femur and the tibia meet the patella or kneecap as this commonly called is made of bone and sits in front of the knee. The knee joint is a synovial joint, synovial joint is enclosed by a ligament capsule and contain a fluid called synovial fluid that lubricates the joint 股骨末端与胫骨顶部连接形成膝关节，在股骨末端有两个圆形的突起叫做股骨髁。这些股骨髁位于胫骨的上表面这个表面被称为胫骨平台。离另一个膝关节最远的外侧一半被称为外侧胫骨平台，最靠近另一个膝关节的内侧被称为内侧胫骨平台。 The end of the femur joins the top of the tibia to create the knee joint, two round knobs called Femoral Condyles are found on the end of the femur. These condyles rest on the top surface of the tibia, this surface is called the Tibial Plateau. The outside half the farthest away from the other knee is called the lateral tibial plateau and the inside half closest to the other knee is called the medial tibial plateau. 髌骨通过由两个股骨髁形成的特殊凹槽滑动称为髌股凹槽，略小于小腿的骨头。 The patella glides through a special groove formed by the two Femoral Condyles called the Patellafemoral groove，the smaller bone of the lower leg. 腓骨从未真正参与膝关节构成，的确有一个小关节把它和胫骨连接起来。这个关节通常不怎么动。 The fibula never really enters the knee joint. He does have a small joint that connects it to the side of the tibia. This joint normally moves very little. 关节软骨 关节软骨是覆盖任何关节边界末端的物质。这种材料在大多数大关节处大约有四分之一英寸厚。它是白色的，有光泽，像橡胶一样坚韧。 Articular cartilage is the material that covers the ends of the bounds of any joint. This material is about one quarter of an inch thick in most large joints. It is white and shiny, with a rubbery consistency. 关节软骨是一种光滑的物质，允许表面相互滑动而不损害任何表面关节，软骨的功能是吸收冲击和提供一个非常光滑的表面，以促进运动。 Articular cartilage is a slippery substance that allows the surfaces to slide against one another without damage to either surface. The function of articular cartilage is to absorb shock and provide an extremely smooth surface to facilitate motion. 我们基本上到处都有关节软骨，用以骨性表面或关节间彼此相对移动。在膝关节，关节软骨覆盖着股骨的末端、胫骨的顶部和髌骨的后面。 We have articular cartilage essentially everywhere that too bony surfaces move against one another or articulate. In the knee， articular cartilage covers the ends of the femur, the top of the tibia and the back of the patella. 韧带 Ligaments 韧带是连接骨头两端的坚韧组织。在膝关节的每一边都有两条重要的韧带，它们是内侧副韧带或称MCL 外侧副韧带或称LCL。 Ligaments are tough bands of tissue that connect the ends of bones together. Two important ligaments are found on either side of the knee joint, they are the medial collateral ligament or MCL and the lateral collateral ligament or LCL. 在膝关节内部，两条重要的韧带在股骨和胫骨之间伸展前交叉韧带 ACL，在前方以及后方的后交叉韧带或PCL 。 Inside the knee joint, two other important ligaments stretch between the femur and the tibia, the anterior cruciate ligament or ACL in front and the posterior cruciate ligament or PCL in the back. MCL和LCL可以防止膝盖在左右方向过度移动，ACL和PCL控制膝关节的前后运动。ACL可以防止胫骨相对于股骨向前滑得太远。PCL防止胫骨相对于股骨向后滑得太远。 The MCL and the LCL prevent the knee from moving too far in the side to side direction. The ACL and the PCL control the front to back motion of the knee joint. The ACL keeps the tibia from sliding too far forward in relation to the femur. The PCL keeps the tibia from sliding too far backward in relation to the femur working together. 共同协作，两个十字韧带控制膝关节的前后运动。韧带是控制膝关节稳定性的最重要的结构。 Working together, the two cruciate ligaments control the back and forth motion of the knee. The ligaments all taken together are the most important structures controlling the stability of the knee. 半月板 Meniscus 两种特殊类型的韧带叫做半月板，位于股骨和胫骨之间。这些结构有时被称为膝盖软骨，但是半月板不同于覆盖在关节表面的关节软骨。 Two special types of ligaments call meniscus sit between the femur and the tibia. These structures are sometimes referred to as the cartilages of the knee. But the meniscus differ from the articular cartilage that covers the surface of the joint. 给膝盖的两个半月板很重要，原因有两个： 其一，它们像垫圈一样工作，将身体重量的力量分散到更大的区域。二，它们帮助韧带保持膝盖的稳定。 The two meniscus gave the knee are important for two reasons: one they work like a gasket to spread the force from the weight of the body over a larger area. and two, they helped the ligaments with stability of the knee. 想象膝盖是一个球，放在一个平板上。球是股骨髁，平面是胫骨平台，半月板实际上缠绕在股骨髁周围，填补股骨髁和平坦的胫骨平台之间的空隙。半月板的作用就像一个垫圈帮助将重量从股骨分配到胫骨。 Imagine the knee is a ball resting on a flat plate, the ball is the condyles of the femur and the plate is the tibial plateau. The meniscus actually wrap around the round condyles to fill the space between it and the flat tibial plateau. The meniscus act like a gasket helping to distribute the weight from the femur to the tibia 若没有半月板，股骨上的任何重量都会集中在胫骨上的一点上。但是在有半月板的情况下，通过半月板展开胫骨表面的重量分布是很重要的，因为它保护骨骼末端的关节软骨不受过大的力。 Without the meniscus, any weight on the femur will be concentrated to one point on the tibia. But with a meniscus way to spread out across the tibial surface weight distribution by the meniscus is important，because it protects the articular cartilage on the ends of the bones from excessive forces. 没有半月板把力集中在关节软骨的一个小区域会损伤表面，随着时间的推移导致退化。 Without meniscus, the concentration of force into a small area on the articular cartilage can damage the surface, leading to degeneration over time. 除了保护关节软骨，半月板有助于韧带和膝盖的稳定半月板使膝关节更稳定，就像一个楔子设置在汽车轮胎的底部。 In addition to protecting the articular cartilage, the meniscus helped the ligaments with stability of the knee. The meniscus makes the knee joint more stable by acting like a wedge set against the bottom of a car tire. 外侧的半月板较厚，这种厚度有助于防止圆形股骨在平面上滚动。半月板将胫骨表面变成一个浅窝，浅窝比平板上的圆球在传递上肢力量时更稳定、更有效。半月板增强了膝盖的稳定性保护关节软骨不受过度集中的力。 The meniscus is thicker around the outside and this thickness helps keep the round femur from rolling on the flat tibia. The meniscus converts the tibial surface into a shallow socket. The socket is more stable and more efficient at transmitting the weight from the upper body than a round ball on a flat plate. The meniscus enhances the stability of the knee and protect the articular cartilage from excessive concentration of force. 总而言之，膝关节的韧带是稳定关节的最重要的结构。记住，韧带连接骨头和骨头，没有坚固的紧密韧带来连接股骨和胫骨，膝关节会太松。 Taken all together, the ligaments of the knee of the most important structures that stabilize the joint. Remember, ligaments connect bones to bones. Without strong tight ligaments to connect the femur to the tibia, the knee joint would be too loose. 不像身体的其他关节，膝关节缺乏稳定的骨骼结构。例如，髋关节是一个球位于一个很深的窝里。踝关节的形状类似榫头，采用了工匠们使用了几个世纪的木头连接方法。 Unlike other joints in the body, the knee joint lacks a stable bony configuration. The hip joint, for example, is a ball that sits inside a deep socket. The ankle joint has a shape similar to a mortise tenon a way of joining wood used by craftsmen for centuries. 肌腱 Tendons 肌腱与韧带相似，只是肌腱将肌肉附着在骨骼上。四头肌腱连接大腿股四头肌和髌骨。 该肌腱继续穿过髌骨（膝盖骨）并与髌韧带融合，髌韧带连接髌骨和胫骨。 Tendons are similar to ligaments except that tendons attach muscles to bones. The quadriceps tendon connects the large quadriceps muscle of the thigh to the patella, this tendon continues across the patella or kneecap and blends into the patellar tendon. The patellar tendon connects the patella to the tibia. 大腿后部的腘绳肌也有肌腱，这些肌腱在膝关节周围的不同位置相连。这些肌腱有时被用作肌腱移植物，以取代膝关节撕裂的韧带。 The hamstring muscles on the back of the thigh also have tendons that attach in different places around the knee joint. These tendons are sometimes used as tendon grafts to replace torn ligaments in the knee joint. 伸肌装置是驱动膝关节并允许我们行走的动力，它位于膝关节前面，由膝盖骨、髌韧带、四头肌腱和四头肌组成。 The extensor mechanism is the motor that drives the knee joint and allows us to walk. It sits in front of the knee joint and is made up of the patella the patellar tendon the quadriceps tendon and the quadriceps muscles. 大腿前面的四块股四头肌是与股四头肌腱相连的肌肉。当这些肌肉收缩时，可以伸直膝关节 比如当你从蹲姿站起来的时候。 The four quadriceps muscles in front of the thigh are the muscles that are attached to the quadriceps tendon. When these muscles contract they straighten the knee joint such as when you get up from a squatting position. 膝盖骨与股骨前部的髌股沟槽配合的方式以及在膝关节弯曲时滑动的方式会影响膝盖的整体功能。髌骨就像一个支点，在伸膝的时候增加股四头肌的力量。 The way in which the knee cap fits into the patellafemoral groove on the front of the femur and slides as the knee bends can affect the overall function of the knee. The patella works like a fulcrum, increasing the force exerted by the quadriceps muscles as the knee straightens. 腘绳肌是大腿后部的大块肌肉当这些肌肉收缩时膝盖弯曲。 The hamstring muscles are the large muscles in the back of the thigh. When these muscles contract the knee bends. 神经和血管 Nerves and Vessels 膝关节周围最重要的神经是膝后的胫神经和腓总神经。这两条神经传导到小腿和脚，提供感觉和肌肉控制。 The most important nerves around the knee are the tibia nerve and the common peroneal nerve in the back of the knee. These two nerves traveled to the lower leg and foot supplying sensation and muscle control. 大的坐骨神经就在膝盖上方分开形成胫神经和腓总神。经胫骨神经一直延伸到腿的后部，而腓总神经从膝盖外侧开始，从大腿前部到脚部。这两种神经都可能因膝盖周围的损伤而受损。 The large sciatic nerve splits just above the knee to form the tibia nerve and the common peroneal nerve. The tibia nerve continues down the back of the leg, while the common peroneal travels around the outside of the knee and down the front of the leg to the foot. Both of these nerves can be damaged by injuries around the knee. 膝盖周围的主要血管和胫神经一起向下延伸到腿的后部，腘动脉和腘静脉是腿部和足部最大的血供。如果腘动脉受损到无法修复的地步，这条腿很可能无法存活。腘动脉输送血液到腿和脚，腘静脉将血液带回心脏。 The major blood vessels around the knee travel with the tibia nerve down the back of the leg. Popliteal artery and the Popliteal vein are the largest blood supply to the leg and foot. If the popliteal artery is damaged beyond repair it is very likely the leg will not be able to survive. The popliteal artery carries blood to the leg and foot, the popliteal vein carries blood back to the heart. 总结Summary 膝盖的设计有些不稳定，但它必须在站立时支撑身体的全部重量，而在行走或跑步时必须支撑更多的重量。因此 膝盖问题是各个年龄段的人相当普遍的困扰也就不足为奇了。了解膝盖的基本部位可以帮助你更好地了解膝盖问题发生时的情况。 The knee has a somewhat unstable design yet it must support the body's full weight when standing and much more than that during walking or running. So, it's not surprising that knee problems are a fairly common complaint among people of all ages. Understanding the basic parts of the knee can help you better understand what happens when knee problems occur. |
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