Muscle architecture of vastus medialis obliquus and longus and its functional implications: A three‐dimensional investigation

Castanov, Valera; Hassan, Syed Ahmed; Shakeri, Shayan; Vienneau, Maxine; Zabjek, Karl; Richardson, Denyse; McKee, Nancy H.; Agur, Anne

doi:10.1002/ca.23344

Cited by 28 publications

(21 citation statements)

References 43 publications

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“…The superficial layer was the VAM which extended from the proximal opening of the adductor canal to the adductor magnus tendon. The deep layer was the VMOA, an aponeurosis which has been reported to originate from the adductor magnus tendon 16 17. This finding would account for the US description of the VAM, at the distal adductor canal, by Wong et al as having a ‘double contour’ 9…”

Section: Discussionmentioning

confidence: 78%

Evaluation of the proximal adductor canal block injectate spread: a cadaveric study

Tran

Chan

Peng

et al. 2019

Reg Anesth Pain Med

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Background and objectives Quadriceps sparing adductor canal block has emerged as a viable intervention to manage pain after total knee arthroplasty. Recent studies have defined ultrasound (US) landmarks to localize the proximal and distal adductor canal. US-guided proximal adductor canal injection has not been investigated using these sonographic landmarks. The objectives of this cadaveric study were to evaluate dye injectate spread and quantify the capture rates of nerves supplying articular branches to the knee joint capsule using a proximal adductor canal injection technique. Methods A US-guided proximal adductor canal injection with 10 mL of dye was performed in seven lightly embalmed specimens. Following injection, specimens were dissected to document dye spread and frequency of nerve staining. Results Following proximal adductor canal injection, dye spread consistently stained the deep surface of sartorius, vastoadductor membrane, aponeurosis of the vastus medialis obliquus, and adductor canal. The saphenous nerve, posteromedial branch of nerve to vastus medialis, superior medial genicular nerve and genicular branch of obturator nerve were captured in all specimens at the proximal adductor canal. There was minimal to no dye spread to the distal femoral triangle, anterior division of the obturator nerve and anterior branches of nerve to vastus medialis. Conclusions This anatomical study provides some insights into the mechanism of analgesia to the knee following a proximal adductor canal injection and its motor sparing properties. Further clinical investigation is required to confirm cadaveric findings.

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Section: Discussionmentioning

confidence: 78%

Evaluation of the proximal adductor canal block injectate spread: a cadaveric study

Tran

Chan

Peng

et al. 2019

Reg Anesth Pain Med

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“…The primary function of the VMO was medial stabilization of the patella throughout extension. This view has been supported by several authors [9][10][11]. The quadriceps heads (specifically the VM) are suspected to play a role in pain and degenerative changes in the femoropatellar and femorotibial joints [10].…”

Section: Introductionmentioning

confidence: 84%

“…The current study provides an insight for the morphology of the VMO and its participation in anterior knee pain. A closer look at the VM reveals that the uppermost fibers (VML) are more vertically oriented while the lower fibers (VMO) are more obliquely oriented [11]. VMO has received moderate attention as potentially being more responsible for medial tension on the patella.…”

Section: Discussionmentioning

confidence: 99%

Morphometric analysis of vastus medialis oblique muscle and its influence on anterior knee pain

et al. 2021

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Healthy knees require full range squatting movements. Vastus medialis (VM) muscle regulates and adjusts the extensor apparatus that influences the patellofemoral function. This work was designed to investigate the anatomy and morphometry of vastus medialis oblique (VMO) muscle by widely used imaging techniques and investigate how VMO muscle participates in anterior knee pain. Ten dissected cadaveric specimens were examined, focusing on fiber orientations, origin, insertions and nerve supply of VMO muscle. Magnetic resonance imaging and ultrasound of VMO muscle were recorded. Anatomical cross-sectional areas of VMO muscle were determined in painless and painful knees and statistically analyzed. In cadaveric specimens, there was distinct separation between VM longus and VMO (change in fiber angle or fibrofascial plane). VMO inserted directly into the medial proximal margin of the patella, capsule of the knee joint and continuous with the patellar tendon. Separate branch of femoral nerve run along the anteromedial border of the muscle. Anatomical cross-sectional area was significantly decreased in painful knee by-17.2%±11.0% at lower end of shaft of femur,-21.1%±6.0% at upper border of patella,-36.7%±11.0% at mid-patellar level. VMO is distinct muscle within quadriceps femoris group. VMO muscle would track the patella medially and participate in last phase of knee extension. Assessment of the VMO muscle anatomical cross-sectional area by ultrasonography may constitute promising and reliable tool to evaluate patellofemoral pain syndrome staging.

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“…The Autodesk® Maya® software (Autodesk, San Jose, CA, USA) and the Rhinoceros® software (McNeel, Seattle, WA, USA) were used for virtual simulations. Thissoftware's have already been used in many medical papers as tools for 3D modeling and simulation [12][13][14].…”

Section: Virtual Simulation Using Two 3d Programsmentioning

confidence: 99%

“…The change of posterior slope was measured using a MicroScribe™ system (Revware Systems, Inc., USA). The reported accuracy of the device is ± 0.05mm [14]. To measure the change of posterior slope with a MicroScribe™ system, two holes were made in advance in the square column model.…”

Section: Spoimentioning

confidence: 99%

The Effect of Sagittal Plane Inclination on Posterior Tibial Slope in Medial Open Wedge HTO – Experimental Study With a Square Column Model-

Moon

Ryu

Lee

et al. 2020

Preprint

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Background: Medial open-wedge high tibial osteotomy (MOWHTO) is an effective and safe treatment method in medial osteoarthritis of knee. However, it may accompany unintended change of posterior tibial slope (PTS). Several factors are known to cause PTS change after MOWHTO. However, there is a lack of research on the sagittal plane osteotomy inclination (SPOI). The purpose of this study was to evaluate that SPOI affected the change in PTS. The hypothesis was that parallel SPOI causes no PTS change after MOWHTO. Methods:A square column model with a 10° posterior slope was produced by two 3D programs and a 3D printer. A series of MOWHTO was performed on a square column model through virtual simulation using two 3D programs and an actual simulation using a 3D printer, a testing machine and a measurement system. The SPOI was divided into 4 types: ① parallel SPOI plus 10° (SPOI: 20°), ② parallel SPOI (SPOI: 10°), ③ perpendicular SPOI (SPOI: 0°), and ④ perpendicular SPOI minus 10° (SPOI: -10°). The correction angle was increased by 5° from 0° to 30°. The change of the posterior slope was measured in sagittal plane.Results: The posterior slope was increased in the parallel SPOI plus 10° (SPOI: 20°). It was maintained in the parallel SPOI (SPOI: 10°) and decreased in the perpendicular SPOI (SPOI: 0°) and perpendicular SPOI minus 10° (SPOI: -10°).Conclusion: SPOI affected the change in PTS. Parallel SPOI causes no PTS change after MOWHTO.

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Muscle architecture of vastus medialis obliquus and longus and its functional implications: A three‐dimensional investigation

Cited by 28 publications

References 43 publications

Evaluation of the proximal adductor canal block injectate spread: a cadaveric study

Evaluation of the proximal adductor canal block injectate spread: a cadaveric study

Morphometric analysis of vastus medialis oblique muscle and its influence on anterior knee pain

The Effect of Sagittal Plane Inclination on Posterior Tibial Slope in Medial Open Wedge HTO – Experimental Study With a Square Column Model-

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