The Anatomy of the Posterior Aspect of the KneeAn Anatomic Study

Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, R200, Minneapolis, MN 55454, USA.
The Journal of Bone and Joint Surgery (Impact Factor: 5.28). 04/2007; 89(4):758-64. DOI: 10.2106/JBJS.F.00120
Source: PubMed


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.
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.
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.
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.

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Available from: Robert F LaPrade, May 09, 2015
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    • "Indeed, myofascial expansions, inserting into the muscular fascia, have been described for the temporalis buccinator , coracobrachialis, and semitendinosus and semimembranosus tendons [Ferreira, 1966; Ray et al., 2004; LaPrade et al., 2007; Tuncay et al., 2007]. From the radiological point of view, at the best of our knowledge, this is the first study showing the non-pathologic imaging of the brachial fascia. "
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    ABSTRACT: The aim of this study was to analyse the relationships between the expansions of the pectoral girdle muscles, i.e. pectoralis major, latissimus dorsi and deltoid, and the brachial fascia. Thirty shoulder specimens from 15 unembalmed adult cadavers were studied by dissection and in vivo radiological studies were performed in 20 patients using magnetic resonance (MR) imaging. The clavicular part of the pectoralis major muscle sent a fibrous expansion onto the anterior portion of the brachial fascia, its costal part onto the medial portion and medial intermuscular septum. The latissimus dorsi muscle showed a triangular fibrous expansion onto the posterior portion of the brachial fascia. The posterior part of the deltoid muscle inserted muscular fibres directly onto the posterior portion of the brachial fascia, its lateral part onto the lateral portion and the lateral intermuscular septum. In MR images, the brachial fascia appeared as a low-signal-intensity sinuous line of connective tissue, sharply delineated in T(1)-weighted sequences. The expansions of the pectoral girdle muscles onto the brachial fascia were present in all the subjects and showed a quite constant course with a specific spatial organization. During the various movements of the arm, these expansions stretch selective portions of the brachial fascia, with possible activation of specific patterns of fascial proprioceptors.
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    ABSTRACT: This paper reports a novel method for reconstructing the posterolateral structures [lateral collateral ligament (LCL), popliteus tendon, popliteofibular ligament] based on an anatomical study of a cadaveric dissection. The popliteus tendon was found to always be attached to the anterior–inferior portion of the femoral attachment site of the LCL, and the average distance from the origin of the popliteal tendon in the femoral side to that of the LCL was 18.5mm (17–20). The insertion site of the LCL in the fibular side was located anterior–inferior-superficially and the popliteofibular ligament was inserted into the posterior–superior-deep portion around the styloid process. Two femoral tunnels and one fibular head tunnel were made at the proximal and distal portion of the anatomical insertion sites.
    Archives of Orthopaedic and Trauma Surgery 03/2008; 129(3):381-385. DOI:10.1007/s00402-008-0722-7 · 1.60 Impact Factor
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