Functional anatomy of the posterolateral structures of the knee

Watanabe, Yasuhiko; Moriya, Hideshige; Takahashi, Kenji; Yamagata, Masatsune; Sonoda, Masaki; Shimada, Yutaka; Tamaki, Toru

doi:10.1016/s0749-8063(05)80344-5

Cited by 196 publications

(111 citation statements)

References 9 publications

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“…Some structures, such as the arcuate and fabellofibular ligaments, are not always present [43,48,55]. In addition, the popliteofibular ligament was not recognised for some years, despite it being a direct ligamentous attachment from the femur to the fibula that is wellaligned to resist tibial external rotation [32].…”

Section: Functional Anatomymentioning

confidence: 99%

The effects of lateral meniscal allograft transplantation techniques on tibio-femoral contact pressures

McDermott

Lie

Edwards

et al. 2008

Knee Surg Sports Traumatol Arthr

110

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This paper reviews and updates our knowledge of the anatomy and biomechanics of the posterior cruciate ligament, and of the posterolateral, posteromedial and meniscofemoral ligaments of the knee. The posterior cruciate ligament is shown to have two functional fibre bundles that are tight at different angles of knee flexion. It is the primary restraint to tibial posterior draw at all angles of knee flexion apart from near full extension. In contrast, the posterolateral and posteromedial structures are shown to tighten as the knee extends, and to be well-aligned to resist tibial posterior draw. These structures also act as primary restraints against other tibial displacements. Tibial internal rotation is restrained by the medial and posteromedial structures, while tibial external rotation is restrained by the lateral and posterolateral structures. They are also the primary restraints against tibial abduction-adduction rotations. The meniscofemoral ligaments are shown, for the first time, to contribute significantly to resisting tibial posterior draw, and to have a strength of approximately 300 N. Taken together, this evidence shows how the posterolateral and posteromedial structures are responsible for posterior knee stability near extension, and this, along with the action of the meniscofemoral ligaments, may explain why an isolated rupture of the posterior cruciate ligament does not often lead to knee instability

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Section: Functional Anatomymentioning

confidence: 99%

The effects of lateral meniscal allograft transplantation techniques on tibio-femoral contact pressures

McDermott

Lie

Edwards

et al. 2008

Knee Surg Sports Traumatol Arthr

110

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“…knee joint. The medial and lateral heads fuse in a single muscle belly occupying the posterior superficial compartment of the lower leg [41,45]. Deep to the gastrocnemius there is the soleus, a large flat, pennate muscle [14].…”

Section: Introductionmentioning

confidence: 99%

Achilles tendon: functional anatomy and novel emerging models of imaging classification

Buono

Chan

Maffulli

2012

International Orthopaedics (SICOT)

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Purpose Ideally, a classification should have some prognostic value, and should therefore include precise information upon extent and location of the Achilles tendon disorders. We propose a new imaging and anatomical system to classify Achilles tendon disorders at imaging using US and MRI. Approach We consider the non-insertional region as the tendon mid-portion, and distinguish the insertional component into a pre-insertion site, located about two centimetres above the calcaneum, and a calcaneal insertion, where the tendon is attached to the bone. On sagittal scans, we introduced a new classification which considers two main portions: "musculotendinous" and "insertional". In the context of the muscolotendinous portion, it is possible to find muscle fibres proximally, and the free tendon distally. This latter is made up of proximal, middle and distal portions. We also propose a 5 grade Doppler classification system to quantify blood flow, in which Grades I and II are respectively characterised by the presence of one and two vessels within the tendon; in Grades III, IV and V, the neovascularisation respectively involves less than 50 %, from 50 to 90 %, and more than 90 % of the tendon tissue. These proposed systems will require validation and possible modification to be applied to different tendons.

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“…Os estabilizadores adicionais da articulação são o ligamento colateral lateral e o tendão do bíceps femoral (quando o joelho está em extensão), o tendão poplíteo e o ligamento poplíteo fibular (3,9,12) . Com o joelho em flexão, a cabeça fibular migra anteriormente enquanto relaxa o ligamento colateral lateral e o tendão do músculo bíceps femoral perdendo estabilidade (1,(13)(14)(15) . Além da articulação proximal, a tíbia e a fíbula possuem entre si a sindesmose distal, que pode ser lesada no mesmo trauma (9) .…”

Section: Classificaçãounclassified

Luxação aguda isolada da articulação tibiofibular proximal

Silvares¹,

Guerreiro²,

Müller³

et al. 2010

Rev. bras. ortop.

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REsUMOA luxação traumática isolada da articulação tibiofibular proximal é rara. Esta lesão pode não ser reconhecida ou diagnosticada no atendimento inicial. A ausência de suspeita clínica pode causar problemas para o diagnóstico. O diagnóstico necessita de história precisa do mecanismo e sintomas da lesão, avaliação clínica e radiográfica adequada de ambos joelhos. Casos não reconhecidos são fonte de alterações crônicas. O tratamento é feito por redução fechada e imobilização ou, em casos irredutíveis ou instáveis, redução aberta com fixação interna temporária. Um caso raro de luxação tibiofibular proximal isolada em um jogador de basquetebol é relatado para ilustrar essa lesão. INtRODUçãOAs lesões na face lateral do joelho são menos frequentes que as mediais. Os ligamentos laterais, inserções tendíneas e a fíbula proximal protegem, mas podem dificultar o exame e o diagnóstico de lesões na região (1)(2)(3) . Luxação aguda de articulação tibiofibular proximal é de diagnóstico raro e pode passar despercebido nas salas de pronto atendimento e de emergência (4,5) . Casos negligenciados ou não tratados podem levar à alterações degenerativas da articulação com dor crônica e até disfunção do nervo fibular (6,7) . aNatOMIaA articulação tibiofibular proximal é articulação sinovial entre côndilo tibial lateral e cabeça da fíbula (8,9) . Ao menos 10% da população possui comunicação entre esta articulação e a tibiofemoral, justificando alguns casos de derrame articular discreto no joelho (9,10) . A tibiofibular é articulação naturalmente estável devido à congruência óssea articular, ao envelope musculoligamentar e sua localização posterolateral (7) . A orientação da superfície articular pode variar e levar a maior risco de luxação (1) . As variantes foram definidas como horizontalRev Bras Ortop. 2010;45(4):460-4

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Functional anatomy of the posterolateral structures of the knee

Cited by 196 publications

References 9 publications

The effects of lateral meniscal allograft transplantation techniques on tibio-femoral contact pressures

The effects of lateral meniscal allograft transplantation techniques on tibio-femoral contact pressures

Achilles tendon: functional anatomy and novel emerging models of imaging classification

Luxação aguda isolada da articulação tibiofibular proximal

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