Prenatal development of the human knee and superior tibiofibular joints

Abstract

Departments of Anatornil, Stunford Untorrsity, S t a n f o~d , Cnlzfornici, i r t i d Vayne Unizc rsily Collcge of 1frdicime, Dc,troit, X~c 7 i i . q m SIXTEEIN FIGURES IlSTRODUCTIOSThe majority of reports on the developiiieiit of joints haw emphasized the early stages, and relatively little attention has been paid to cliaiiges during tlie later fetal niontlis aiicl the postnatal period of growth. That striking, unexplained changes d o occur is illustrated by the marked clifferences between fetal and adult sternoclioiidral joints (Gray and Garclner, '43). A more detailed knowledge of the preand postiiatnl development of these aiid otlier joints is obviously iiecessarjfor a better underi.;tanding of the physiological processes aiicl pathological changes wliicli take place in tlicni. As a result of their studies on the cllcvclopiiieiit of joints, several investigators have at tempted to relate dcvrlopneiitnl changes to either genetic or niechanical factors. IIeiikc and Reyher (1874) were among the first of these, and tlicp coiieluded that movement is the factor which deterniincs tlie form of articular structure. Tlicir conclusions u7ei.e later supported by Schulin (1879)' Hagen-Torn (1882), and Toriiiei. (1894).The developmerit of the kiiee has heen studied more tliaii that of any other joint. In 1878 Bernays published his Classical work oil its tlereloprneiit in man and other aninials mid Aided by a grant from the L)i,ision of Rcsenrclr Grants and Fellonships.

Histochemical Studies on the Histogenesis of the Knee Joint and Superior Tibio-Fibular Joint in Human Foetuses

“…This corres ponds to the findings in the pisiform bone (A n dersen, unpublished data) and digital sesamoids (Gray, Gardner an d O 'R a h illy [1957|). At the same time, it affords an explanation of the interzone between the patella and the femur which m any authors have interpreted as being non-blastemal (H a in es 1194*71; Gray and Gardner [1950|). At 20 mm this zone was found to be a dense, blastemal tissue merging proximally into the femoral perichondrium and dem arcated proximo-anteriorly by the tissue where the m. articularis genu develops.…”

“…The two chondrogenous layers continue in the perichondria of the respective cartilages, whereas the avascular interm ediate layer extends peripherally into a vascular mesenchyme, the so-called synovial mesenchyme. Gray and Gardner (1950], at least as far as the simpler joints are concerned. However, Gray and Gardner did not quite accept H aines' theory in respect to the knee joint, as it did not afford an explana tion how a single interzone turns into two-one for each femorotibial condylar region.…”

A new insight into the fabella at knee: the foetal development and evolution

“…The establishment in foetuses of the muscle belly, including the tendinous origin of the gastrocnemius, may be followed by the appearance of the cartilaginous fabella, depending on the activities of muscles that move the knee and ankle. This developmental sequence is quite different from those of the cartilaginous femur, tibia and fibula, in that they start to develop earlier than their associated muscles, tendons and ligaments [6,9]. Moreover, in adults, the fabella is sometimes or often absent and, even if present, it often fails to contact to the knee joint (see above).…”

Cartilage attachment morphology of the fetal cruciate ligaments of the knee: an immunohistochemical study using human fetal specimens

“…Behr et al (2001) described that the femoral attachment of the human ACL shows a simple and superficial continuation of the perichondrium at 23 weeks and, later at and near 36 weeks, the strong insertion is formed to a deep bony fovea of the femur. Since previous studies concentrated onto the early development from the interzone mesenchyme (Gray and Gardner, 1950;Haines, 1953;Andersen, 1961;Doskocil, 1984; Mérida-Velasco et al, 1997; Ratajczak, 2000), we have few morphological information about bony attachment morphologies of the fetal cruciate ligaments. An exceptional descrip-Summary: Fetal cruciate ligaments of the knee provide two types of cartilage attachments: to a cartilage fovea or a simple continuation to the perichondrium.…”

“…During development of the cartilage fovea, the growing ligament seemed to push the perichondrium into the cartilage and, much or less, the tenascin-positive perichondrium was likely to be involved into the fovea. tion was found in Gray and Gardner (1950) who paid attention to a distinct difference between the tibial and femoral attachments of the PCL at 15.5 weeks: a compact and small insertion at the tibial end in contrast to a large spreading femoral end.…”