The plantaris muscle has been given little attention in the reviewed literature. It is most commonly mentioned only when absent from a specimen. This study aimed to document the anatomy of the plantaris muscle and to discuss the clinical significance of the observations. Cadaveric knees (n = 46) were dissected to identify the possible variations of the plantaris muscle. The muscle conformed with standard descriptions (n = 26; 56.52%), was present but varied from previous descriptions (n = 14; 30.44%), or was absent (n = 6; 13.04%). The variations consisted of distinct interdigitations with the lateral head of the gastrocnemius muscle (n = 9; 19.57%) and a strong fibrous extension of the plantaris muscle to the patella (n = 5; 10.87%). The presence of interdigitations strengthen the argument that the plantaris muscle supplement the activity of the lateral head of the gastrocnemius muscle whereas the patellar extension suggests an involvement with patellofemoral dynamics and may play a role in the various presentations of patellofemoral pain syndrome. Greater understanding of the relationship between these and other posterior knee structures will facilitate more precise interpretation and treatment of knee injuries.
The outcome of high tibial osteotomy (HTO) deteriorates with time, and additional procedures may be required. The aim of this study was to compare the clinical and radiological outcomes between unicompartmental knee replacement (UKR) and total knee replacement (TKR) after HTO as well as after primary UKR. A total of 63 patients (63 knees) were studied retrospectively and divided into three groups: UKR after HTO (group A; n = 22), TKR after HTO (group B; n = 18) and primary UKR (group C; n = 22). The Oxford knee score (OKS), Knee Society score (KSS), hip-knee-ankle angles, mechanical axis and patellar height were evaluated pre- and post-operatively. At a mean of 64 months (19 to 180) post-operatively the mean OKS was 43.8 (33 to 49), 43.3 (30 to 48) and 42.5 (29 to 48) for groups A, B and C, respectively (p = 0.73). The mean KSS knee score was 88.8 (54 to 100), 88.11 (51 to 100) and 85.3 (45 to 100) for groups A, B and C, respectively (p = 0.65), and the mean KSS function score was 85.0 (50 to 100) in group A, 85.8 (20 to 100) in group B and 79.3 (50 to 100) in group C (p = 0.48). Radiologically the results were comparable for all groups except for patellar height, with a higher incidence of patella infra following a previous HTO (p = 0.02).
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