The Anatomy of the Posterior Aspect of the Knee An Anatomic Study (original) (raw)
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The Anatomy of the Posterior Aspect of the KneeAn Anatomic Study
The Journal of Bone and Joint Surgery (American), 2007
Background: The orthopaedic literature contains relatively little quantitative information regarding the anatomy of the posterior aspect of the knee. The purpose of the present study was to provide a detailed description of, and to propose a standard nomenclature for, the anatomy of the posterior aspect of the knee.
The Anatomy of the Posterior Aspect of the Knee
The Journal of Bone & Joint Surgery, 2007
Background: The orthopaedic literature contains relatively little quantitative information regarding the anatomy of the posterior aspect of the knee. The purpose of the present study was to provide a detailed description of, and to propose a standard nomenclature for, the anatomy of the posterior aspect of the knee. Methods: Detailed dissection of twenty nonpaired, fresh-frozen knees was performed. Posterior knee structures were measured according to length, width, and/or distance to reproducible osseous landmarks. Results: The semimembranosus tendon had eight attachments distal to the main common tendon. The main components were a lateral expansion to the oblique popliteal ligament; a direct arm, which attached to the tibia; and an anterior arm. The oblique popliteal ligament, the largest posterior knee structure, formed a broad fascial sheath over the posterior aspect of the knee and measured 48.0 mm in length and 9.5 mm wide at its medial origin and 16.4 mm wide at its lateral attachment. It had two lateral attachments, one to the meniscofemoral portion of the posterolateral joint capsule and one to the tibia, along the lateral border of the posterior cruciate ligament facet. The semimembranosus also had a distal tibial expansion, which formed a posterior fascial layer over the popliteus muscle. A thickening of the posterior joint capsule, the proximal popliteus capsular expansion, which in this study averaged 40.5 mm in length, connected the posteromedial knee capsule at its attachment at the intercondylar notch to the medial border of the popliteus musculotendinous junction. The plantaris muscle, popliteofibular ligament, fabellofibular ligament, and semimembranosus bursa were present in all specimens. Conclusions: The anatomy of the posterior aspect of the knee is quite complex. This study provides information that can lead to further biomechanical, radiographic imaging, and clinical studies of the importance of these posterior knee structures.
The American journal of sports medicine
Quantitative descriptions of the attachment sites of the main posterolateral knee structures have not been performed. To qualitatively and quantitatively determine the anatomic attachment sites of these structures and their relationships to pertinent bony landmarks. Cadaveric study. Dissections were performed and measurements taken on 10 nonpaired fresh-frozen cadaveric knees. The fibular collateral ligament had an average femoral attachment slightly proximal (1.4 mm) and posterior (3.1 mm) to the lateral epicondyle. Distally, it attached 8.2 mm posterior to the anterior aspect of the fibular head. The popliteus tendon had a constant broad-based femoral attachment at the most proximal and anterior fifth of the popliteal sulcus. The popliteus tendon attachment on the femur was always anterior to the fibular collateral ligament. The average distance between the femoral attachments of the popliteus tendon and fibular collateral ligament was 18.5 mm. The popliteofibular ligament had two...
Anatomical Study of the Posterolateral Ligament Complex of the Knee: LCL and Popliteus Tendon
Acta Ortopédica Brasileira, 2021
Objective: To analyse the distances between the femoral insertions of the popliteus tendon (PT) and the lateral collateral ligament (LCL) through dissections of cadaveric specimens in a mixed population. Methods: Fresh cadavers were dissected, and the anthropometric data of all specimens were recorded. The distances from the origin of the PT to the LCL in the femoral region and the diameter of each structure were measured using a digital calliper. Results: In total, 11 unpaired knees were dissected, eight men and three women, with an average age of 71.5 ± 15.2 years, weight of 57.2 ± 15.6 kg, and a mean height of 170.5 ± 8.2 cm. The distance from the center of the femoral footprint of the LCL to the PT was 10.0 ± 2.4 mm. The distances between the edges closest to each other and those more distant from each other were 3.1 ± 1.1 mm and 16.3 ± 2.4 mm, respectively. Conclusion: The distance between the midpoints of the PT and the LCL in our mixed population is smaller than the distances...
The Journal of Bone and Joint Surgery. British volume, 2003
Techniques for the selective cutting of ligaments in cadaver knees defined the static contributions of the posterolateral structures to external rotation, varus rotation and posterior tibial translation from 0° to 120° of flexion under defined loading conditions. Sectioning of the popliteofibular ligament (PFL) (group 1) produced no significant changes in the limits of the knee movement studied. Sectioning of the PFL and the popliteus tendon (femoral attachment, group 2) produced an increase of only 5° to 6° in external rotation from flexion of 30° to 120° (p < 0.001). Even when other ligaments were sectioned first (group 3), the maximum effect of the PFL was negligible. Our findings show that the popliteus muscle-tendon-ligament complex, lateral collateral ligament, and posterolateral capsular structures function as a unit. No individual structure alone is the primary restraint for the movements studied. Operative reconstruction should address all of the posterolateral structure...
Posterior oblique ligament of the knee: state of the art
EFORT Open Reviews
The posterior oblique ligament (POL) is the predominant ligamentous structure on the posterior medial corner of the knee joint. A thorough understanding of the anatomy, biomechanics, diagnosis, treatment and rehabilitation of POL injuries will aid orthopaedic surgeons in the management of these injuries. The resulting rotational instability, in addition to valgus laxity, may not be tolerated by athletes participating in pivoting sports. The most common mechanism of injury – accounting for 72% of cases – is related to sports activity, particularly football, basketball and skiing. Moreover, three different injury patterns have been reported: those associated with injury to the capsular arm of the semimembranosus (SM), those involving a complete peripheral meniscal detachment and those involving disruption of the SM and peripheral meniscal detachment. The hallmark of an injury related to POL lesions is the presence of anteromedial rotatory instability (AMRI), which is defined as ‘exter...
Anatomical variations in the anatomy of the posterolateral corner of the knee
Knee Surgery, Sports Traumatology, Arthroscopy, 2007
This cadaveric study of 22 knees described the anatomy of the deeper structures of the posterolateral corner, the popliteus-tendon complex, arcuate ligament complex, the popliteofibular ligament, and the coronary ligament. Most variations occurred in the popliteofibular ligament; the variations and the different nomenclatures used in the literature for these structures make it difficult to diagnose and repair injuries to them. Untreated injuries may result in chronic functional instability to the posterolateral corner of the knee.
Anatomic Relation Between the Posterior Cruciate Ligament and the Joint Capsule
Arthroscopy-the Journal of Arthroscopic and Related Surgery, 2008
The aim of this anatomic study on cadavers was to determine the anatomic relation between the posterior cruciate ligament (PCL) and the posterior joint capsule attachment. Methods: Thirty knees were dissected by means of a posterior approach to the knee. The presence of the posterior popliteal ligament and Wrisberg meniscofemoral ligament was observed and a U-shaped capsulotomy was performed while preserving the distal insertion of the ligament. After detaching the PCL and determining its area on the tibia, we determined its geometric center and posterior margin and measured the distances between the tibial insertion of the capsule and these points. Results: The distance between the center of the PCL and the posterior capsule was 10.3 mm, and the distance between the posterior margin of the PCL and the capsule was 1.7 mm. The posterior popliteal ligament was easy to see in all the specimens, measuring around 42 mm in length. The Wrisberg meniscofemoral ligament was seen in 12 specimens. Conclusions: We can conclude that the distances from the center of the tibial insertion and the margin of the PCL to the joint capsule were 10.3 mm and 1.7 mm, respectively, thus enabling greater knowledge of the anatomy of the posterior compartment of the knee. Clinical Relevance: Our findings provide anatomic data that increase the safety and knowledge regarding the surgical procedures related to the PCL, because we have supplied information that can contribute to obtaining the best arthroscopic view of this area, thus decreasing the risk of vascular and nerve damage.
International Journal of Morphology, 2017
To reveal the detailed morphological features of the fibular collateral (fibular) ligament, popliteus tendon, popliteofibular ligament and the synovial components regarding to achieve data for surgical and biomechanical utilization. Knees of 10 formalin-fixed male cadavers were dissected bilaterally. Bursae around the lateral collateral ligament and the relation of popliteus tendon with lateral collateral ligament at the femoral attachment site were noted. The positional relation between both ends of popliteofibular ligament was evaluated statistically. The PT exceeded the anterior margin of lateral collateral ligament in 11 sides, the posterior margin of lateral collateral ligament in 3 sides and exceeded both the anterior and posterior margins of lateral collateral ligament in 5 sides. The shape of lateral collateral ligament was narrower at the lower part than the upper in 14 sides. The width of lower part of lateral collateral ligament was found narrower in the cases with sheath-like bursa (vagina synovialis). The relation between both ends of popliteofibular ligament was as followed: the more anteriorly the fibular head attachment was located, the more anteriorly popliteofibular ligament was attached to the popliteus tendon. To resolve the posterolateral corner of the knee with regard to surgical anatomy and biomechanics, individual and concerted morphometric characteristics of lateral collateral ligament, popliteus tendon and PF should be evaluated together with accompanied synovial structures.
The Anatomy of the Medial Part of the Knee
2000
Background: While the anatomy of the medial part of the knee has been described qualitatively, quantitative descriptions of the attachment sites of the main medial knee structures have not been reported. The purpose of the present study was to verify the qualitative anatomy of medial knee structures and to perform a quantitative evaluation of their anatomic attachment sites as well as their relationships to pertinent osseous landmarks.