The Boundary of the Vastus Medialis Oblique and the Vastus Medialis Longus

Ono, Takeya; Riegger‐Krugh, Cheryl; Bookstein, Nancey A.; Shimizu, Michele Eisemann; Kanai, Setsuko; Otsuka, Akira

doi:10.1589/jpts.17.1

Cited by 11 publications

(14 citation statements)

References 5 publications

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“…1 b, e, f). This pattern has also been reported in other studies 2,12,14) . Other authors, however, found no specific pattern of innervation 9,13) .…”

Section: Discussionsupporting

confidence: 91%

“…However, we found the mean VML fibre angle to be 5°, with a range between −10° to 12°, whereas numerous other authors have reported this angle to be 15-18° (e.g. 2,9,12,14) ). We found this to be almost exactly the angle of the VMO at the division between VMO and VML It is striking that what we found to be the fibre angle of the most proximal fibres of the VMO so closely resembles the mean VML fibre angle reported by some previous authors, and that the VMO/VML separation reported here is so much more proximal than expected.…”

Section: Discussioncontrasting

confidence: 85%

“…Scharf et al 11) reported a separate femoral nerve branch to the distal portion of the muscle in their entire sample of 115 limbs. Ono et al 14) reported similar findings in a sample of 2 lower limbs. Other studies, however, have contradicted these findings 9,12,13) , reporting no specific pattern of innervation and concluding therefore that VM should be considered to be a single muscle.…”

Section: Introductionmentioning

confidence: 52%

“…Numerous authors have since reported similar findings (e.g. 3,[9][10][11][12][13][14] ). However a spectrum of differing conclusions has been drawn, with some authors specifically stating that the difference in fibre angle does not mean that the two parts of the muscle are functionally different, and should not therefore be considered as individual muscles 12,13) .…”

Section: Introductionmentioning

confidence: 64%

“…However, some have been quite specific in describing the location of the division. Ono et al 14) found it to be at the level of the adductor hiatus, Peeler et al 9) described the VMO as that part of the vastus medialis below the uppermost point of muscle fibre insertion into the quadriceps tendon, while Bose et al 19) described the VMO as originating from the tendon of the adductor magnus. All of these levels are significantly more distal than the level of separation found in this study, which we found to be on average in the proximal third of the VM (Fig.…”

Section: Discussionmentioning

confidence: 99%

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Vastus Medialis: a Reappraisal of VMO and VML

Skinner

Adds

2012

J Phys Ther Sci

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Abstract.[Purpose] The morphology and innervation pattern of the vastus medialis (VM) were investigated to determine if there was an anatomical distinction between the oblique (VMO) and longus (VML) parts. [Subjects and Methods] Forty lower limbs were dissected. The innervation pattern was observed in 39 specimens. Muscle length and fibre angles of 14 specimens were recorded.[Results] In 22 specimens there was a distinct separation between the VML and VMO (change in fibre angle, fibrofascial plane, vasculature or nerve branch). The mean fibre angle of VMO was 52°, and the mean VML fibre angle was 5° (relative to the shaft of the femur). Ten limbs (25.6%) had separate innervation to the VML. The separation between VMO and VML was found to be more proximal than expected, with the VMO on average accounting for 70% of the VM, in contrast to the much more distal point of separation reported elsewhere, leading us to raise the possibility that VML and vastus intermedius may have been misidentified in some previous studies. [Conclusions] In conclusion the VML/VMO division (when present) is much more proximal than has been previously reported, and there is no consistent pattern of innervation to the two parts of the muscle.

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“…1 b, e, f). This pattern has also been reported in other studies 2,12,14) . Other authors, however, found no specific pattern of innervation 9,13) .…”

Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 85%

Section: Introductionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

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Vastus Medialis: a Reappraisal of VMO and VML

Skinner

Adds

2012

J Phys Ther Sci

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Do the vastus medialis obliquus and vastus medialis longus really exist? A systematic review

et al. 2008

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There remains controversy over whether the vastus medialis (VM) is a single anatomical structure or whether it is composed of two separate portions, the vastus medialis longus (VML) proximally and the vastus medialis obliquus (VMO) distally. The objective of this study was to assess the evidence base of investigations into muscle fiber orientation, presence of a fibrofascial plane, and the innervation of the VM in human cadaver specimens and subjects. In addition to a hand search of specialist journals, an electronic search of AMED, British Nursing Index, CINAHL, the Cochrane database, EMBASE, ovid Medline, Pubmed, and Zetoc were performed from their inception to September 2008. All human subject papers assessing VM fiber orientation, presence of a fibrofascial plane, and the innervation of the VM where reviewed. Twenty-six papers, assessing 699 healthy knees, and 591 specimens with patellofemoral dysfunction were reviewed. The majority of nonpathological and pathological cases presented with a substantial alteration in fiber alignment seen between proximal and distal muscle portions of VM. Both cohorts presented with either one or two nerve branches to the VM. A fibrofascial plane dividing these two muscles was seen in a small proportion of both pathological and nonpathological knees. There was, however, insufficient good quality evidence to state whether the VM is composed of two separate components, the proximal VML and the distal VMO. Further study is recommended to evaluate the pathophysiological implications of such findings and to assess whether these correlate to functional electromyographic findings between the VML and VMO muscles.

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

et al. 2019

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Vastus medialis (VM) has two partitions, longus (VML), and obliquus (VMO), which have been implicated in knee pathologies. However, muscle architecture of VMO and VML has not been documented volumetrically. The aims of this study were to determine and compare the muscle architecture of VMO and VML in three-dimensional (3D) space, and to elucidate their relative functional capabilities. Twelve embalmed specimens were used in this study. Each specimen was serially dissected, digitized (Microscribe™ MX), and modeled in 3D (Autodesk Maya ® ). Architectural parameters: fiber bundle length (FBL), proximal (PPA)/distal (DPA) pennation angle, and physiological cross-sectional area (PCSA) were compared using descriptive statistics/t-tests. Sarcomere lengths (SLs) were measured and compared from six biopsy sites of VM. VMO and VML were found to have superficial and deep parts based on fiber bundle attachments to aponeuroses, medial patellar retinaculum, and adductor magnus tendon. The superficial part of VMO was further subdivided into superior and inferior partitions. Architecturally, VMO was found to have significantly shorter mean FBL, greater mean PPA and DPA, and smaller mean PCSA than VML. VML was found to be connected to the fascia lata by thin fascial bands, not present in VMO. SLs of VMO and VML were comparable. VMO and VML are architecturally and functionally distinct, as evidenced by marked differences in their musculoaponeurotic geometry, attachment sites, and architectural parameters. VMO likely contributes greater to medial patellar stabilization, whereas VML, with a larger relative excursion and force-generating capability, to the extension of the knee. Clin. Anat. 32:515-523, 2019.

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The Boundary of the Vastus Medialis Oblique and the Vastus Medialis Longus

Cited by 11 publications

References 5 publications

Vastus Medialis: a Reappraisal of VMO and VML

Vastus Medialis: a Reappraisal of VMO and VML

Do the vastus medialis obliquus and vastus medialis longus really exist? A systematic review

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

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