Anatomy of the Knee Joint Lateral Retinaculum

Fulkerson, John P.; Gossling, Harry R.

doi:10.1097/00003086-198011000-00025

Cited by 112 publications

(80 citation statements)

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“…Another possible explanation for the discrepancy could relate to the varying descriptions of its location. Fulkerson and Gossling [14], for example, stated the LPFL is the deep layer of the lateral patellar retinaculum distinct from the fibrous capsular layer of the knee. However, others state it is part of the knee capsule [27,32,42].…”

Section: Discussionmentioning

confidence: 99%

Clinical Anatomy of the Quadriceps Femoris and Extensor Apparatus of the Knee

Waligora

Johanson

Hirsch

2009

Clin Orthop Relat Res

122

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Most descriptions of the extensor mechanism of the knee do not take into account its complexity and variability. The quadriceps femoris insertion into the patella is said to be through a common tendon with a threelayered arrangement: rectus femoris (RF) most superficially, vastus medialis (VM) and lateralis (VL) in the intermediate layer, and vastus intermedius (VI) most deeply. We dissected 20 limbs from 17 cadavers to provide a more detailed description of the anterior components of the knee: the tendon, the patellar retinacula, and the patellofemoral ligaments. Only three of the 20 specimens exhibited the typically described quadriceps pattern. The remainder had bilaminar and even more complex trilaminar and tetralaminar fiber arrangements. We found an oblique head of the vastus lateralis (VLO), separated from the longitudinal head by a layer of fat or fascia, in 60% of the specimens. However, we found no distinct oblique head of the vastus medialis (VMO) in any specimen. The medial patellofemoral ligament (MPFL) was more common than the lateral (LPFL), supporting its suggested role as the principal passive medial stabilizer of the patella. Because the quadriceps muscle group plays a direct role in patellofemoral joint function, investigation into the clinical applications of its highly variable anatomy may be worthwhile with respect to joint dysfunction and failures of TKAs.

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Section: Discussionmentioning

confidence: 99%

Clinical Anatomy of the Quadriceps Femoris and Extensor Apparatus of the Knee

Waligora

Johanson

Hirsch

2009

Clin Orthop Relat Res

122

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“…The quadriceps tension distribution was according to physiological cross-sectional areas (PCSAs) of the muscles: RF+VI 35%, VLL 33%, VLO 9%, VML 14%, and VMO 9%. 8 The patella was connected via the embedded ball bearing to the moving rig on the test machine crosshead.…”

Section: Methodsmentioning

confidence: 99%

Effects of lateral retinacular release on the lateral stability of the patella

Christoforakis

Bull

Strachan³

et al. 2005

Knee Surg Sports Traumatol Arthrosc

144

111

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The objective of this cadaveric study was to evaluate quantitatively the effects of lateral retinacular release on the lateral stability of the patella.A materials testing machine was used to displace the patella of 7 cadaveric specimens 10 mm laterally while measuring the required force, with 175 N quadriceps tension. The patella was connected via a ball-bearing patellar mounting 10 mm deep to the anterior surface to allow rotations. Patellar force-displacement behaviour was tested from 0º to 60º knee flexion.At 0°, 10° and 20° flexion the mean force required to displace the patella 10 mm laterally was reduced significantly due to lateral retinacular release, by 16 to 19 %. The average force required to displace the patella was also reduced for larger flexion angles, although this was not statistically significant.These findings suggest that lateral retinacular release may not be appropriate in treatment of patellar lateral instability.

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“…O autor não apresentou com detalhes as inserções femoral e patelar desse ligamento e nem o descreveu com minúcia. Fulkerson et al (32) enfocaram maior atenção às estruturas laterais do joelho e descreveram o LPFL na mesma camada do retináculo transverso profundo. Nesse nível de dissecação, observaram que o LPFL estava inserido na região proximal do epicôndilo lateral femoral e que se conectava à região lateral da patela.…”

Section: Discussionunclassified

“…Concordamos com Fulkerson et al (32) sobre a descrição da inserção do LPFL no fêmur (proximal ao epicôndilo lateral), mas observamos que ocorre uma expansão das fibras em forma de leque no local e existe também alguma inserção posterior ao epicôndilo. Teitge et al (12) , ao descreverem o ponto isométrico no fê-mur do LPFL, durante sua reconstrução cirúrgica, o localizaram no epicôndilo femoral.…”

Section: Discussionunclassified