scholarly journals Morphology of Anterolateral Ligament of the Knee: A Cadaveric Observation with Clinical Insight

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Bhagath Kumar Potu ◽  
Abdel Halim Salem ◽  
Marwan F. Abu-Hijleh
Keyword(s):  
Tibial Plateau ◽  
Histological Analysis ◽  
Femoral Condyle ◽  
Lateral Meniscus ◽  
Anterolateral Ligament ◽  
Structure Relationship ◽  
Ligamentous Structure ◽  
Different Populations ◽  
And Function ◽  
Gerdy’S Tubercle

Background. The morphology and function of anterolateral ligament (ALL) of the knee are not clearly understood even today with all the sophisticated techniques available. There have been differing descriptions of the ALL of the knee in literature, and not all of them have been named or described clearly.Aim. The present study was undertaken to provide a clear structure/relationship description on ALL.Materials and Methods. We used 24 formalin-fixed cadaveric limbs. Knee regions of the all the limbs were neatly dissected and the ALL was exposed. Its proximal and distal attachments were traced carefully. Middle portion of ALL was removed and processed for histological analysis.Results. ALL was found in one right knee (4.16%). It extended distally from the lateral femoral condyle to the lateral tibial plateau margin. Its attachment on the tibial plateau was located between head of the fibula and Gerdy’s tubercle. A strong connection was identified between the ALL and the periphery of the middle third of the lateral meniscus. Histological analysis of ALL confirmed the presence of true ligamentous structure in it with dense connective tissue and plenty of fibroblasts.Conclusion. The prevalence of ALL in different populations along with its clinical significance has been discussed in detail in this paper.

Current Concepts of the Anterolateral Ligament of the Knee: Anatomy, Biomechanics, and Reconstruction

2017 ◽  
Vol 46 (5) ◽  
pp. 1235-1242 ◽  
Author(s):  
Matthew J. Kraeutler ◽  
K. Linnea Welton ◽  
Jorge Chahla ◽  
Robert F. LaPrade ◽  
Eric C. McCarty
Keyword(s):  
Clinical Outcomes ◽  
Internal Rotation ◽  
Proximal Tibia ◽  
Case Series ◽  
Anterolateral Ligament ◽  
Tibial Rotation ◽  
Ligamentous Structure ◽  
Gerdy’S Tubercle ◽  
Tibial Translation ◽  
Tendon Autograft

In 1879, Paul Segond described an avulsion fracture (now known as a Segond fracture) at the anterolateral proximal tibia with the presence of a fibrous band at the location of this fracture. Although references to this ligament were occasionally made in the anatomy literature after Segond’s discovery, it was not until 2012 that Vincent et al named this ligament what we know it as today, the anterolateral ligament (ALL) of the knee. The ALL originates near the lateral epicondyle of the distal femur and inserts on the proximal tibia near Gerdy’s tubercle. The ALL exists as a ligamentous structure that comes under tension during internal rotation at 30°. In the majority of specimens, the ALL can be visualized as a ligamentous structure, whereas in some cases it may only be palpated as bundles of more tense capsular tissue when internal rotation is applied. Biomechanical studies have shown that the ALL functions as a secondary stabilizer to the anterior cruciate ligament (ACL) in resisting anterior tibial translation and internal tibial rotation. These biomechanical studies indicate that concurrent reconstruction of the ACL and ALL results in significantly reduced internal rotation and axial plane tibial translation compared with isolated ACL reconstruction (ACLR) in the presence of ALL deficiency. Clinically, a variety of techniques are available for ALL reconstruction (ALLR). Current graft options include the iliotibial (IT) band, gracilis tendon autograft or allograft, and semitendinosus tendon autograft or allograft. Fixation angle also varies between studies from full knee extension to 60° to 90° of flexion. To date, only 1 modern study has described the clinical outcomes of concomitant ALLR and ACLR: a case series of 92 patients with a minimum 2-year follow-up. Further studies are necessary to define the ideal graft type, location of fixation, and fixation angle for ALLR. Future studies also must be designed in a prospective comparative manner to compare the clinical outcomes of patients undergoing ACLR with ALL reconstruction versus without ALL reconstruction. By discovering the true effect of the ALL, investigators can elucidate the importance of ALLR in the setting of an ACL tear.

scholarly journals Incidence of Displaced Posterolateral Tibial Plateau and Lateral Femoral Condyle Impaction Fractures in the Setting of Primary Anterior Cruciate Ligament Tear

2020 ◽  
Vol 48 (3) ◽  
pp. 545-553 ◽  
Author(s):  
David L. Bernholt ◽  
Nicholas N. DePhillipo ◽  
Matthew D. Crawford ◽  
Zachary S. Aman ◽  
W. Jeffrey Grantham ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tibial Plateau ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Lateral Femoral Condyle ◽  
Lateral Tibial Plateau ◽  
Bone Bruising ◽  
Mri Scans ◽  
Anterior Cruciate

Background: Bone bruising of the posterolateral tibial plateau and the lateral femoral condyle sulcus terminalis has a well-established association with anterior cruciate ligament (ACL) tears. Impaction fractures of the femur and tibia may occur in these locations; however, there is a paucity of literature describing these fractures. Purpose: The primary objective was to quantify the incidence, size, and location of impaction fractures of the posterolateral tibial plateau and lateral femoral condyle in patients with primary ACL tears. The secondary objective was to investigate the association between impaction fractures and concomitant meniscal and ligamentous injuries. Study Design: Case series; Level of evidence 4. Methods: Patients with available magnetic resonance imaging (MRI) scans who were treated for primary ACL tear by a single surgeon were identified. MRI scans were reviewed with denotation of posterolateral tibial and femoral condylar contusions and displaced impaction fractures. Measurements of the lateral tibial plateau were taken in all patients with displaced lateral tibial plateau fractures and in a subset of control patients without tibial plateau fracture present to characterize the size and location of the bony lesion. Associations of impaction fractures with concomitant meniscal or ligamentous injuries were evaluated through use of chi-square testing. Results: There were 825 knees identified with available MRI scans. Lateral tibial plateau bone bruising was present in 634 knees (76.8%), and lateral femoral condyle bone bruising was present in 407 knees (49.3%). Posterolateral tibial plateau impaction fractures were present in 407 knees (49.3%), and lateral femoral condylar impaction fractures were present in 214 knees (25.9%). Patients with posterolateral tibial plateau impaction fractures were older than patients without these fractures (42.6 vs 32.7 years; P < .001), whereas patients with lateral femoral condylar impaction fractures were younger (23.8 vs 32.7 years; P < .001). There were 71 knees (8.6%) with a posterolateral tibial plateau impaction fracture with greater than 10% loss of lateral tibial plateau depth, and this group had an increased incidence of lateral meniscus posterior root tears (22.1% vs 12.0%; P = .02). Conclusion: Posterolateral tibial plateau impaction fractures occurred with a high incidence (49.3%) in patients with primary ACL tears and demonstrated an increased association with lateral meniscus posterior horn root tears as their size increased. Lateral femoral condylar impaction fractures occurred in 25.9% of patients with primary ACL tears and entailed an increased incidence of lateral meniscal tears and medial meniscal ramp lesions.

Isolated Lateral Meniscal Tear in the Dog

1988 ◽  
Vol 01 (03/04) ◽  
pp. 152-154
Author(s):  
S. Johnson ◽  
D. Hulse
Keyword(s):  
External Rotation ◽  
Femoral Condyle ◽  
Meniscal Tear ◽  
Lateral Meniscus ◽  
Surgical Excision ◽  
Human Beings ◽  
Stifle Joint ◽  
Microscopic Pathology ◽  
Bucket Handle Tear ◽  
Bucket Handle

degenerative changes of the involved stifle joint associated with a “bucket handle” tear of the caudal body of the lateral meniscus. Surgical excision of the torn section of meniscus was beneficial in the first patient but this patient had persistant difficulty with the leg after exercise. Gross and microscopic pathology of the involved stifle in the second patient showed the meniscal lesion to be associated with severe cartilage fibrillation of the overlying lateral femoral condyle. As in human beings, the mechanism of injury may have been placement of the foot during vigorous external rotation of the femur with the stifle flexed. Extension of the limb from this position could have resulted in an isolated tear of the lateral meniscus.

scholarly journals Lateral femoral notch sign and posterolateral tibial plateau fractures and their associated injuries in the setting of an anterior cruciate ligament rupture

2021 ◽  
Author(s):  
Alexander Korthaus ◽  
Malte Warncke ◽  
Geert Pagenstert ◽  
Matthias Krause ◽  
Karl-Heinz Frosch ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Ligament Injury ◽  
Ligament Rupture ◽  
Impression Fracture ◽  
Anterior Cruciate ◽  
Lateral Femoral Notch ◽  
Femoral Notch

Abstract Introduction ACL injury is one of the most common injuries of the knee joint in sports. As accompanying osseous injuries of the ACL rupture a femoral impression the so-called lateral femoral notch sign and a posterolateral fracture of the tibial plateau are described. However, frequency, concomitant ligament injuries and when and how to treat these combined injuries are not clear. There is still a lack of understanding with which ligamentous concomitant injuries besides the anterior cruciate ligament injury these bony injuries are associated. Materials and methods One hundred fifteen MRI scans with proven anterior cruciate ligament rupture performed at our center were retrospectively evaluated for the presence of a meniscus, collateral ligament injury, a femoral impression, or a posterolateral impression fracture. Femoral impressions were described according to their local appearance and posterolateral tibial plateau fractures were described using the classification of Menzdorf et al. Results In 29 cases a significant impression in the lateral femoral condyle was detected. There was a significantly increased number of lateral meniscal (41.4% vs. 18.6% p = 0.023) and medial ligament (41.4% vs. 22.1%; p = 0.040) injuries in the group with a lateral femoral notch sign. 104 patients showed a posterolateral bone bruise or fracture of the tibial plateau. Seven of these required an intervention according to Menzdorf et al. In the group of anterior cruciate ligament injuries with posterolateral tibial plateau fracture significantly more lateral meniscus injuries were seen (p = 0.039). Conclusion In the preoperative planning of ACL rupture accompanied with a positive femoral notch sign, attention should be paid to possible medial collateral ligament and lateral meniscus injuries. As these are more likely to occur together. A posterolateral impression fracture of the tibial plateau is associated with an increased likelihood of the presence of a lateral meniscal injury. This must be considered in surgical therapy and planning and may be the indication for necessary early surgical treatment.

Effect of Tibial Tunnel Placement Using the Lateral Meniscus as a Landmark on Clinical Outcomes of Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652199967
Author(s):  
Kadir Büyükdoğan ◽  
Michael S. Laidlaw ◽  
Michael A. Fox ◽  
Michelle E. Kew ◽  
Mark D. Miller
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Lateral Meniscus ◽  
Knee Laxity ◽  
Pivot Shift Test ◽  
Anterior Knee Laxity ◽  
Posterior Group ◽  
Kt 1000 ◽  
Anterior Knee

Background: It remains unclear if use of the lateral meniscus anterior horn (LMAH) as a landmark will produce consistent tunnel positions in the anteroposterior (AP) distance across the tibial plateau. Purpose: To evaluate the AP location of anterior cruciate ligament (ACL) reconstruction tibial tunnels utilizing the LMAH as an intra-articular landmark and to examine how tunnel placement affects knee stability and clinical outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted of 98 patients who underwent primary ACL reconstruction with quadrupled hamstring tendon autografts between March 2013 and June 2017. Patients with unilateral ACL injuries and a minimum follow-up of 2 years were included in the study. All guide pins for the tibial tunnel were placed using the posterior border of the LMAH as an intra-articular landmark. Guide pins were evaluated with the Bernard-Hertel grid in the femur and the Stäubli-Rauschning method in the tibia. Patients were divided by the radiographic location of the articular entry point of the guide pin with relation to the anterior 40% of the tibial plateau. Outcomes were evaluated by the Marx Activity Scale and International Knee Documentation Committee (IKDC) form. Anterior knee laxity was evaluated using a KT-1000 arthrometer and graded with the objective portion of the IKDC form. Rotational stability was evaluated using the pivot-shift test. Results: A total of 60 patients were available for follow-up at a mean 28.6 months. The overall percentage of AP placement of the tibial tunnel was 39.3% ± 3.8% (mean ± SD; range, 31%-47%). Side-to-side difference of anterior knee laxity was significantly lower in the anterior group than the posterior group (1.2 ± 1.1 mm vs 2.5 ± 1.3 mm; P < .001; r = 0.51). The percentage of AP placement of the tibial tunnel demonstrated a positive medium correlation with side-to-side difference of anterior knee laxity as measured by a KT-1000 arthrometer ( r = 0.430; P < .001). The anterior group reported significantly better distribution of IKDC grading as compared with the posterior group (26 grade A and 6 grade B vs 15 grade A and 13 grade B; P = .043; V = 0.297). The pivot-shift test results and outcome scores showed no significant differences between the groups. Conclusion: Using the posterior border of the LMAH as an intraoperative landmark yields a wide range of tibial tunnel locations along the tibial plateau, with anterior placement of the tibial tunnel leading toward improved anterior knee stability.

An imaging measurement study of normal knee parameters in southeast China

2021 ◽  
Vol 17 ◽  
Author(s):  
Huitong Liu ◽  
Bingqiang Xu ◽  
Eryou Feng ◽  
Shizhang Liu ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Plateau ◽  
Femoral Condyle ◽  
Age Groups ◽  
Young Group ◽  
Normal Female ◽  
Valgus Angle ◽  
Significant Difference ◽  
Total Knee

Background: Imaging measurement of distal femur and proximal tibia has been the hot point in the research of total knee arthroplasty and prosthesis development, which is an important treatment for patients with advanced knee joint disease. This study retrospectively investigated the digital imaging measurement of normal knee parameters in southeast China and evaluated their clinical value. Methods: From February 2010 to May 2014, and in accordance with the inclusion criteria, a total of 677 knees (334 female knees and 343 male knees) were categorized into 3 age groups. Clinical and digital imaging data, including the distal femoral condyle diameter (FCD), tibial plateau diameter (TPD), the distance between the medial tibial plateau and fibular head (DPF), tibiofemoral valgus angle, distal femoral valgus angle, proximal tibia (PT) varus angle and the angle from femoral condyle to tibial perpendicular (FT), were measured by using AutoCAD 10.0 software. All measured variables were statistically analyzed by SPSS statistical software (version 18.0). Results: Data are presented as the mean ± standard deviation. The normal female and male femoral condyle diameter was (7.69 ± 0.46) cm and (8.68 ± 0.55) cm, while the normal female and male tibial plateau diameter was (7.66 ± 0.46) cm and (8.60 ± 0.55) cm, respectively. The normal female and male DPF was (0.76 ± 0.36) cm and (0.79 ± 0.36) cm. For females and males, the tibiofemoral valgus angle and distal femoral valgus angle were (3.89 ± 2.20) ° and (3.29 ± 2.12) °, (9.03 ± 2.18) ° and (8.25 ± 2.20) °. As the two methods to measure tibial plateau varus angle, PT angle of normal female and male was (4.29 ± 1.86) ° and (4.84 ± 2.23) °, while the normal female and male FT angle was (5.34 ± 1.95) ° and (5.52 ± 2.07) °. Based on the data obtained, we found significant differences between the two genders in terms of the femoral condyle diameter and tibial plateau diameter in all age groups (P < 0.01). The DPF parameter showed an obvious difference between the young group and the middle-aged group (P < 0.05), and no significant difference was observed between the sides and genders (P > 0.05). The distal femoral valgus angle showed statistical differences between genders in the left side of the young group and middle-aged group (P < 0.05), while angle PT and FT showed no significant difference (P > 0.05). Conclusion: A large number of knee measurements was obtained, and a local knee database was developed in this study. Imaging measurement prior to total knee arthroplasty is clinically important for increasing the accuracy and long-term efficacy of total knee arthroplasty. These data can also provide useful information for knee surgery and sports medicine as well as prosthesis development.

Lateral Meniscus Height and ACL Reconstruction Failure: A Nested Case–Control Study

2021 ◽  
Author(s):  
Iskandar Tamimi ◽  
David Bautista Enrique ◽  
Motaz Alaqueel ◽  
Jimmy Tat ◽  
Almudena Pérez Lara ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Tibial Plateau ◽  
Case Control Study ◽  
Lateral Meniscus ◽  
Case Control ◽  
Lateral Tibial Plateau ◽  
Reconstruction Surgery ◽  
Meniscus Height ◽  
Nested Case Control ◽  
Control Study

AbstractPrevious work has shown that the morphology of the knee joint is associated with the risk of primary anterior cruciate ligament (ACL) injury. The objective of this study is to analyze the effect of the meniscal height, anteroposterior distance of the lateral tibial plateau, and other morphological features of the knee joint on risk of ACL reconstruction failure. A nested case–control study was conducted on patients who underwent an ACL reconstruction surgery during the period between 2008 and 2015. Cases were individuals who failed surgery during the study period. Controls were patients who underwent primary ACL reconstruction surgery successfully during the study period. They were matched by age (±2 years), gender, surgeon, and follow-up time (±1 year). A morphological analysis of the knees was then performed using the preoperative magnetic resonance imaging scans. The anteroposterior distance of the medial and lateral tibial plateaus was measured on the T2 axial cuts. The nonweightbearing maximum height of the posterior horn of both menisci was measured on the T1 sagittal scans. Measurements of the medial and lateral tibial slope and meniscal slope were then taken from the sagittal T1 scans passing through the center of the medial and lateral tibial plateau. A binary logistic regression analysis was done to calculate crude and adjusted odds ratios (ORs) estimates. Thirty-four cases who underwent ACL revision surgery were selected and were matched with 68 controls. Cases had a lower lateral meniscal height (6.39 ± 1.2 vs. 7.02 ± 0.9, p = 0.008, power = 84.4%). No differences were found between the two groups regarding the bone slope of the lateral compartment (6.19 ± 4.8 vs. 6.92 ± 5.8, p = 0.552), the lateral meniscal slope (–0.28 ± 5.8 vs. –1.03 ± 4.7, p = 0.509), and the anteroposterior distance of the lateral tibial plateau (37.1 ± 5.4 vs. 35.6 ± 4, p = 0.165). In addition, no differences were found in the medial meniscus height between cases and controls (5.58 ± 1.2 vs. 5.81 ± 1.2, respectively, p = 0.394). There were also no differences between cases and controls involving the medial bone slope, medial meniscal slope, or anterior posterior distance of the medial tibial plateau. Female patients had a higher medial (4.8 degrees ± 3.2 vs. 3.3 ± 4.1, p = 0.047) and lateral (8.1 degrees ± 5.1 vs. 5.6 degrees  ± 5.6, p = 0.031) tibial bone slope, and a lower medial (5.3 mm ± 1.0 vs. 6.1 mm ± 1.2, p = 0.001) and lateral (6.6 ± 1.0 vs. 7.0 ± 1.2, p = 0.035) meniscus height, and medial (4.3 ± 0.4 vs. 4.8 ± 0.4, p =0.000) and lateral (3.3 ± 0.3 vs. 3.9 ± 0.4, p = 0.000) anteroposterior distance than males, respectively.The adjusted OR of suffering an ACL reconstruction failure compared to controls was 5.1 (95% confidence interval [CI]: 1.7–14.9, p = 0.003) for patients who had a lateral meniscus height under 6.0 mm. The adjusted OR of suffering an ACL reconstruction failure was 2.4 (95% CI: 1.0–7.7, p = 0.01) for patients who had an anteroposterior distance above 35.0 mm. Patients with a lateral meniscal height under 6.0 mm have a 5.1-fold risk of suffering an ACL reconstruction failure compared to individuals who have a lateral meniscal height above 6.0 mm. Patients with a higher anteroposterior distance of the lateral tibial plateau also have a higher risk of ACL reconstruction failure.

scholarly journals Neurodivergent Themed Neighbourhoods as A Strategy to Enhance the Liveability of Cities: The Blueprint of an Autism Village, Its Benefits to Neurotypical Environments

Urban Science ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 42 ◽  
Author(s):  
Eurydice Chan
Keyword(s):  
Autism Spectrum Disorder ◽  
Built Environment ◽  
Well Being ◽  
Autism Spectrum ◽  
Design Guidelines ◽  
Spectrum Disorder ◽  
Different Populations ◽  
Limited Option ◽  
Living Environments ◽  
And Function

In the next decades, it is expected that there will be a significant number of adults living with Autism Spectrum Disorder (ASD) who will continue to strive in the neurotypical environment. Despite the recent rise of developments that deviate from the institutional type of facility, many parents continue to voice their struggle to find safe and appropriate living environments for their adult children. The problem is not just the limited option on where to live, financing a home is also another dilemma. Thus, the challenge to provide appropriate living environments coincide with the need to provide meaningful opportunities that allows them to thrive and function in the society. This paper explores the existing design guidelines through recommendations on how spaces can be articulated by considering the value of savant skills and productive vocational skills for individuals living with ASD. This optimistic approach hopes to enlighten built environment practitioners in designing spaces where different populations can co–exist, particularly those with varied abilities. The environmental needs of ASDs and the proposed spatial interventions also extend its benefits to the well–being of neurotypicals. In addition, the participation of the ASD population in the built environment bridges accessibility and spatial experience. Therefore, designing neurodivergent neighbourhoods can be employed as a strategy to improve and enhance the liveability of urban regions.

Anterolateral Ligament of the Fetal Knee: An Anatomic and Histological Study

2016 ◽  
Vol 45 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Camilo Partezani Helito ◽  
Julio Augusto do Prado Torres ◽  
Marcelo Batista Bonadio ◽  
José Aderval Aragão ◽  
Lucas Nogueira de Oliveira ◽  
...  
Keyword(s):  
Fetal Development ◽  
Type I Collagen ◽  
Histological Study ◽  
Lateral Meniscus ◽  
Lateral Collateral Ligament ◽  
Anterolateral Ligament ◽  
Type I ◽  
En Bloc ◽  
Lateral Epicondyle ◽  
Histological Features

Background: The anterolateral ligament (ALL) of the knee has recently been described in detail. Most studies of the ALL have been conducted in adults; therefore, little is known about the anatomy and histology of the ALL in younger patients, and nothing is known about the fetal presence of the ALL. Purpose: To evaluate the ALL in human fetuses to determine its presence or absence and to describe its microscopic anatomy and histological features compared with the findings of studies conducted in adults. Study Design: Descriptive laboratory study. Methods: Twenty human fetal cadaveric specimens were used. The mean age of the fetuses was 28.64 ± 3.20 weeks. The ALL was dissected in the anterolateral region of the knee, and its anatomic parameters, including its origin, insertion, and path in relation to known adjacent anatomic landmarks, in addition to its length, width, and thickness over the path toward the tibia, were measured. After dissection, the ALL was removed en bloc with a portion of the lateral meniscus for histological analysis of 4-μm sections, hematoxylin and eosin staining, and immunohistochemical staining for type I collagen. Results: The ALL was located in all dissected knees. Its origin was located at a mean distance of 1.87 mm from the origin of the lateral collateral ligament, with variations from the center of the lateral epicondyle to posterior and proximal to it, and it exhibited an anterior-inferior path toward the tibia, an insertion in the lateral meniscus approximately 2.08 mm anterior to the popliteal tendon, and another insertion in the tibia between the Gerdy tubercle and the fibular head at 2.46 mm below the articular cartilage. The histological sections of the ALL showed well-organized, dense collagenous tissue fibers with elongated fibroblasts (mean, 1631 fibroblasts/mm2) and a predominance of type I collagen. Conclusion: The ALL is present during fetal development, with anatomic and histological features similar to those of the adult ALL. Clinical Relevance: The findings of this study help to better understand the ALL’s anatomy and histology from the fetal period to adulthood. The study presents the existence of the ALL since fetal development, emphasizes the characterization of the ALL, and brings important information to future pediatric ALL lesion studies.

Internal Structural Connections in the Popliteal Muscle Tendon Complex and Their Clinical Significance

2021 ◽  
Author(s):  
WenBin Jiang ◽  
Shi-Zhu Sun ◽  
Ting-Wei Song ◽  
Chan Li ◽  
Wei Tang ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Knee Joint ◽  
Tibial Plateau ◽  
Lateral Meniscus ◽  
Posterior Edge ◽  
Dense Connective Tissue ◽  
Human Knee ◽  
Articular Capsule ◽  
Adjacent Structures ◽  
Popliteus Muscle

Abstract Background:The popliteal muscle-tendon complex (PMTC) belongs to the deep structure of the posterolateral complex (PLC) of human knee, which plays an important role in the posterolateral stability of the knee joint. At present, the anatomical relationship between the popliteal muscle and its adjacent structures remains controversial, especially the posterior cruciate ligament (PCL) and popliteal muscle. The revealation of anatomical connection between the popliteus muscle and its deep structures could provide an anatomical basis for the reconstruction of the PLC injury.Methods: To observe and analyze the relationship between popliteal muscle and the PCL, posterior meniscofemoral ligament (PMFL), lateral meniscus and articular capsule (AC). The dissection of 7 cases of adult human knee joint fixed with formalin, and 9 cases of sagittal P45 plastinated section of the knee joint were involved in this study. Results: For the popliteal muscle, the anatomical dissection showed that at the posterior edge of the platform of the lateral condyle of the tibia, at the tendon-muscle transition, from medial to lateral, separately sent out: dense connective tissue to connect with the PCL, dense fiber bundles to connect with the PMFL, and dense connective tissue band to connect the lateral meniscus. Meanwhile, the results of the P45 section revealed that the popliteal muscle fascia ran superiorly over the posterior edge of the tibialintercondylar eminence, andturned forward to be integrated into the PCL. Laterally, near the posterior edge of the lateral tibial plateau, the popliteal tendon penetrates through the articular capsule, where two dense fiberous bundleswere given off upwards by the popliteal tendon: one was the ventral fiber bundle,which ran superiorly over the posterior edge of the tibial plateau and then moved forwards to connect with the lateral meniscus; the dorsal fibersbundle ascended directly and participated in the AC.Conclusion: Popliteus muscle was connected with PCL, AC, lateral meniscus, and PMFL via the dense connective tissues near its tendon-muscle transition.

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