Anatomical study of the lateral collateral ligament and its circumference structures in the human knee joint

Abstract

Thirty-six cadavers (55 sides) were used to observe the innervation of the lateral collateral ligament (LCL) and its circumference structures with gross anatomical and histological methods to clarify the cause of indistinct pain in the lateral part of the knee joint. The innervating branches of the LCL could be divided into three types: (1) from the muscular branch of the biceps femoris muscle at lower 1/3 level of the thigh; (2) from the common fibular nerve (CFN) at the higher level of the fossa poplitea; (3) from the CFN at the level of the caput fibular. Furthermore, the three branches could singly or plurally distribute to the LCL (six types). Two of the connecting tissue membranes surrounding the surface of LCL formed an incomplete sheath structure, and a shutting "gap" was observed between the two membranes. Fine peripheral nervous branches were also observed in the two of the membranes. On the other hand, three types of nerve endings in the LCL (Type I/Ruffini mechanoreceptor; Type III/Golgi mechanoreceptor; Type IV/free nerve ending) were observed, and their presence was consistent with the ankle joint of humans. Therefore, the innervation of the two membranes (to form the shutting gap) in the surface of LCL may be associated with an indistinct pain when the knee joint is damaged.

Anatomical Reconsideration of the Lateral Collateral Ligament in the Human Knee: Anatomical Observation and Literature Review

“…We previously investigated the LCL in 55 knees [8]. Here, we report our unpublished data from that study as well as our observations from the present investigation (total 71 knees).…”

“…The surface of the LCL is overlapped by the fabellofibular ligament and the tendon of the biceps femoris [25,34]. However, Yan et al reported that there is an "incomplete gap" between the tendon of the biceps femoris and the surface of the LCL [8]. Based on the present results, this "gap" is not on the surface of LCL alone, but also extends to the deep portions of the LCL near its fibular attachment.…”

“…In our previous study, an "incomplete gap" [8] between the surface of the LCL and the deep portion of the tendon of the biceps femoris was observed (Figure 3). In the present study, the gap was found to possibly extend into the deep portion of the LCL, especially to the lower part of the LCL (Figure 3).…”

“…The articular branches of the knee joint in humans and cats may be supplied by branches of the sciatic nerve, but no detailed routes and distribution patterns of the nerve branches are described [37][38][39]. Yan et al [8] demonstrated that the nerves distributed to the LCL could be classified into 3 types with 6 patterns. The nerve innervating the LCL could be a single nerve branch or multiple branches stemming from a common fibular nerve.…”

Restoration of Joint Inclination in Total Knee Arthroplasty Offers Little Improvement in Joint Kinematics in Neutrally Aligned Extremities

“…The force elements of the medial collateral ligament (MCL), lateral collateral ligament (LCL), PCL, patellar tendon, quadriceps, hamstrings and biceps were incorporated into the models. The origin and insertion points of the various ligaments were referenced from literature ( Edwards et al, 2007 ; LaPrade et al, 2007 ; Yan et al, 2010 ). The MCL was considered as an anterior, oblique and deep fiber bundle, the PCL was considered as an anterior and a posterior fiber bundle, and the LCL was considered as a single fiber bundle ( Abdel-Rahman and Hefzy, 1998 ).…”