An anatomic study on the attachment of the joint capsule to the tibia in the lateral side of the knee

Nasu, Hisayo; Nimura, Akimoto; Sugiura, Sara; Fujishiro, Hitomi; Koga, Hideyuki; Akita, Keiichi

doi:10.1007/s00276-017-1942-8

Cited by 19 publications

(20 citation statements)

References 27 publications

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“…Some researchers4, 10, 15 reported cases with infraglenoid tubercle avulsion fracture and argued that it could be caused by contraction of the LHT. As far as the knee joint is concerned, at the area where Segond’s avulsion fracture is triggered, the developed uncalcified fibrocartilage is found 20 . We consider that although the origin of the LHT on the bone endures mechanical stress within an acceptable range, an overloaded traction could affect the infraglenoid tubercle resulting in an avulsion fracture.…”

Section: Discussionmentioning

confidence: 95%

An anatomic study on the origin of the long head of the triceps brachii

et al. 2019

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Background Posterior shoulder instability was reported to be more common than had been previously reported. However, the detailed morphology of the origin of the long head of the triceps brachii (LHT), which is located at the posteroinferior part of the glenohumeral joint and associated with the stability of the head of the humerus, has been unknown. The purpose of the current study was to clarify the detailed morphology of the origin of the LHT. Methods A total of 64 specimens from 36 cadavers (11 males and 25 females) were used. After dissecting the origin of the LHT in 54 specimens of 27 cadavers, the width of the origin of the LHT was measured with a caliper by 2 observers. The origin of the LHT was also investigated histologically in 18 specimens. Sections were analyzed with Masson’s trichrome staining and Safranin O staining. Results Some fibers of the LHT originated more from the cranial area than from the infraglenoid tubercle and descended along the posterior rim of the glenoid cavity. The width of the origin on the dorsal surface of the scapula was 31.2 mm. The origin from the bone had a developed uncalcified fibrocartilage histologically. In addition, the LHT was fused with the glenohumeral joint capsule and was attached to the glenoid labrum directly. Conclusions The LHT could affect the glenohumeral joint capsule or the glenoid labrum because of their connections to each other and be associated with the posterior shoulder instability indirectly.

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Section: Discussionmentioning

confidence: 95%

An anatomic study on the origin of the long head of the triceps brachii

et al. 2019

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“…33 In addition, the lateral meniscus is more vulnerable to extrusion because of its anatomic features, such as the existence of the popliteal hiatus and fragility of the attachment site of the meniscotibial capsular ligament just anterior to the popliteal hiatus. 14,23 Therefore, lateral meniscal defects without previous surgery or after meniscectomy (especially in cases of the discoid lateral meniscus) often lead to secondary OA of the lateral compartment, 1,5,10,26 and treatment is difficult, especially in patients who undertake a high level of sporting activity. Surgical treatment options for such patients, especially young athletes, have thus far been limited to arthroscopic debridement, distal femoral osteotomy, and meniscal allograft transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…Even if the meniscectomy is not extended to the popliteal hiatus, fragility of the attachment site of the meniscotibial capsular ligament just anterior to the popliteal hiatus results in loosening of the capsular ligament, leading to extrusion. 14,23 Consequently, there are quite a few cases with rapid progression of OA after lateral meniscectomy. This predisposition is stronger in patients with discoid lateral meniscus.…”

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Two-Year Outcomes After Meniscoplasty by Capsular Advancement With the Application of Arthroscopic Centralization Technique for Lateral Compartment Knee Osteoarthritis

et al. 2020

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Background: A high prevalence of osteoarthritis (OA) progression in patients with lateral meniscal defects has been reported. However, optimal management techniques for active patients remain ill-defined. Hypothesis: Meniscoplasty by capsular advancement with the application of the centralization technique would improve clinical and radiological outcomes in patients with lateral compartment OA attributed to lateral meniscal defects. Study Design: Case series; Level of evidence, 4. Methods: A total of 27 patients were enrolled who had undergone meniscoplasty by capsular advancement for lateral compartment OA attributed to lateral meniscal defects. In these patients, the meniscotibial capsule was released from the tibia and advanced with the remaining meniscus onto the rim of the tibial plateau to reform a meniscus-like configuration. Measures of clinical outcomes included clinical examination, Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Knee injury and Osteoarthritis Outcome Score (KOOS), subjective rating scales regarding recovery of the operated knee, and sports performance level. Measures of radiographic outcomes included meniscal extrusion width or regeneration of the meniscus-like tissue on magnetic resonance imaging and lateral joint space width on standing extension anteroposterior and Rosenberg views. All clinical and radiographic outcomes were reported preoperatively and 2 years postoperatively, except magnetic resonance imaging findings, which were reported preoperatively and 1 year postoperatively. Results: The clinical outcomes were significantly improved 2 years postoperatively as compared with baseline: Lysholm score, IKDC subjective score, and KOOS subscores (all P < .0001). The patients’ subjective recovery ( P < .0001) and sports performance level ( P < .0001) were also improved. One year postoperatively, 10 of 11 patients who had no meniscus remaining at the middle segment showed more than one-third the volume of meniscal tissue–like regeneration, and meniscal extrusion width was significantly reduced as compared with baseline in the remaining 16 patients ( P = .0006). Joint space width increased at 2 years on the standing anteroposterior view ( P < .0001) and the Rosenberg view ( P = .0001). Conclusion: Meniscoplasty of the lateral meniscus by capsular advancement improved clinical and radiographic outcomes at 2-year follow-up in patients with lateral compartment OA attributed to lateral meniscal defects.

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“…Так, одні дослідники проводять ультрасонографічне дослідження АЛЗ у положенні згинання колінного суглоба під кутом 90° [20], інші -під кутом 30° [17] [25]. З іншого боку, наявність у місці прикріплення до великогомілкової кістки за даними частини з вчених цієї ж групи в попередніх роботах "ентезису" та некальцифікованого фіброзного хряща свідчить про суттєві механічні навантаження [24] та є типовою для зони прикріплення до кістки зв'язок та сухожилків [26,27]. До того ж наявність кількох структур, що об'єднуються в одному "ентезисі", не є таким вже незвичним явищем в анатомії людини та відзначається в різних ділянках [26,28].…”

Section: результати та їх обговоренняunclassified

“…Відповідно до результатів нещодавно проведених досліджень H. Nasu та ін. (2020) щодо анатомії антеролатеральної капсули суглоба, цей горбок може відповідати зоні прикріплення суглобової капсули [24]. Зона прикріплення антеролатеральної зв'язки до великогомілкової кістки, за отриманими нами даними УЗД, досить широка у всіх пацієнтів та вкриває поверхню цього горбка.…”

Section: результати та їх обговоренняunclassified

Methodology of Ultrasonographic Examination of the Anterolateral Ligament of the Knee Joint

Kostrub¹,

Котюк²,

Osadcha³

et al. 2020

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Summary. Injury of the anterolateral ligament (ALL) accompanies more than half of the anterior cruciate ligament ruptures. However, the uncertainty in the anatomy of ALL raises many questions regarding its visualization on ultrasound. There are also very few ultrasonographic studies of the ALL in the scientific literature in the era of MRI and CT. Objective: to determine the optimal methods and techniques for identifying and improving the visualization of the ALL with ultrasonography. Materials and Methods. ALL ultrasonography was performed in 30 healthy volunteers without pathology of the knee joint on both knee joints using a linear high-frequency sensor (ACUSON NX2 Elite, 10 MHz) at different angles of bending and rotation. Results. Ultrasonography was able to visualize the ALL in all 30 patients as a fibrillar anisotropic structure. The distinctiveness of the ALL was significantly different between patients. It was easiest to find and visualize it well with an extended knee joint, and to assess the integrity and tension when bending the knee joint at an angle of 60° and in the maximum internal rotation of the lower leg. A clearly visible tubercle was revealed by ultrasonography at the site of attachment of the ALL to the tibia in 100% of patients, which has not been described previously and greatly facilitates its finding. There was a history of a violation of the integrity of the cortical layer at the site of attachment of the ALL to the tibia in 26.67% of patients without pathology of the knee joint and injuries. Ultrasonographic identification of the two-layer structure of the ALL failed. The femoral part of the ALL is usually woven into the initial part of the fibular collateral ligament and cannot be separated ultrasonographically from it. In all 30 patients with relatively healthy knee joints without traumatic pathology, the ALL in the contralateral joints looked similar, without statistically significant deviations in their morphometric parameters. Conclusions. Ultrasonography visualizes the tibial and femoral parts of the ALL particularly but not exclusively during movements; however, it almost does not show meniscus bundles separately. For a better visualization of the ALL and assessment of its integrity, we recommend starting its research with an extended knee joint, and then performing functional tests by alternating internal and external rotation of the lower leg at different angles of flexion of the knee joint. The starting point of the ALL is the origin of the fibular collateral ligament from the lateral condyle of the femur, and the reference point of attachment is the tubercle on the anterolateral surface of the tibia posterior to Gerdy tubercle uncovered by us with ultrasonography in all the patients, which is an important reference point that allows faster, easier, and more confident localization of the ALL tibial portion insertion site. On a healthy contralateral joint, the ALL can serve as a reference for comparison if its rupture is suspected.

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An anatomic study on the attachment of the joint capsule to the tibia in the lateral side of the knee

Abstract: The attachment width of the knee joint capsule at the lateral side varied according to location. We consider that this finding on the capsular attachment will facilitate an understanding of the pathology or mechanism of diseases on the lateral side of the knee joint.

Cited by 19 publications

References 27 publications

An anatomic study on the origin of the long head of the triceps brachii

An anatomic study on the origin of the long head of the triceps brachii

Two-Year Outcomes After Meniscoplasty by Capsular Advancement With the Application of Arthroscopic Centralization Technique for Lateral Compartment Knee Osteoarthritis

Methodology of Ultrasonographic Examination of the Anterolateral Ligament of the Knee Joint

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