Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2017

01-01-2017 | Knee

Morphology of the fibular insertion of the posterolateral corner and biceps femoris tendon

Authors: Hirotaka Takahashi, Goro Tajima, Shuhei Kikuchi, Jun Yan, Yoichi Kamei, Moritaka Maruyama, Atsushi Sugawara, Takaaki Saigo, Minoru Doita

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2017

Login to get access

Abstract

Purpose

To clarify the fibular head insertion of the fibular collateral ligament (FCL), popliteofibular ligament (PFL), and biceps femoris tendon and related osseous landmarks on three-dimensional (3-D) images.

Methods

Twenty-one non-paired, formalin-fixed human cadaveric knees were evaluated in this study. The fibular head insertions of the FCL, PFL and biceps femoris tendon were identified and marked. 3-D images were created, and the surface area, location, positional relationships, and morphology of the fibular insertions of the FCL, PFL, and biceps femoris tendon and related osseous structures were analysed.

Results

The fibular head had a unique pyramidal shape, and the relationships of the fibular insertion of the FCL, PFL, and biceps femoris tendon were consistent. The fibular head consists of three aspects: lateral aspect, posterior aspect, and proximal tibiofibular facet. The insertions of the FCL, PFL, and biceps femoris tendon were attached to the centre from the distal side of the lateral aspects of the fibular head, posterior aspect of the fibular styloid process, and lateral aspect surrounding the FCL, respectively. The mean surface areas of the FCL and PFL fibular insertions were 100.1 ± 29.5 and 18.5 ± 7.2 mm2, respectively.

Conclusion

This study showed that the relationships between the characteristic features of the fibular head and insertions of the FCL, PFL, and biceps femoris tendon were consistent. The clinical relevance of this study is that it improves understanding of the anatomy of the insertions of the PLC and biceps femoris tendon.
Literature
1.
Black BS, Stannard JP (2015) Repair versus reconstruction in acute posterolateral instability of the knee. Sports Med Arthosc 23:22–26CrossRef
2.
3.
Brinkman JM, Schwering PJ, Blankevoort L, Koolos JG, Luites J, Wymenga AB (2005) The insertion geometry of the posterolateral corner of the knee. J Bone Joint Surg Br 87:1364–1368CrossRefPubMed
4.
Collins MS, Bond JR, Crush AB, Stuart MJ, King AH, Levy BA (2015) MRI injury patterns in surgically confirmed and reconstructed posterolateral corner knee injuries. Knee Surg Sports Traumatol Arthrosc 23:2943–2949CrossRefPubMed
5.
Gali JC, Bernardes Ade P, dos Santos LC, Ferreira TC, Almagro MA, da Silva PA (2016) Tunnel collision during simultaneous anterior cruciate ligament and posterolateral corner reconstruction. Knee Surg Sports Traumatol Arthrosc 24:195–200CrossRefPubMed
6.
Geeslin AG, LaPrade RF (2010) Location of bone bruises and other osseous injuries associated with acute grade III isolated and combined posterolateral knee injuries. Am J Sports Med 38:2502–2508CrossRefPubMed
7.
Geeslin AG, LaParde RF (2011) Outcomes of treatment of acute grade-III isolated and combined posterolateral knee injuries. J Bone Joint Surg Am 93:1672–1683CrossRefPubMed
8.
Gelaude F, Vander Sloten J, Lauwers B (2008) Accuracy assessment of CT-based outer surface femur meshes. Comput Aided Surg 13:188–199CrossRefPubMed
9.
Harner CD, Höher J, Vogrin TM, Carlin GJ, Woo SL (1998) The effects of a popliteus muscle load on in situ forces in the posterior cruciate ligament and on knee kinematics. A human cadaveric study. Am J Sports Med 26:669–673PubMed
10.
Kannus P (1989) Nonoperative treatment of grade II and III sprains of the lateral ligament compartment of the knee. Am J Sports Med 17:83–88CrossRefPubMed
11.
Kim JG, Ha JG, Lee YS, Yang SJ, Jung JE, Oh SJ (2009) Posterolateral corner anatomy and its anatomical reconstruction with single fibula and double femoral sling method: anatomical study and surgical technique. Arch Orthop Trauma Surg 129:381–385CrossRefPubMed
12.
Kuzuma SA, Chow RM, Engasser WM, Stuart MJ, Levy BA (2014) Reconstruction of the posterolateral corner of the knee with achilles tendon allograft. Arthosc Tech 3:393–398CrossRef
13.
LaPrade RF, Terry GC (1997) Injuries to the posterolateral aspect of the knee. Association of anatomic injury patterns with clinical instability. Am J Sports Med 25:433–438CrossRefPubMed
14.
LaPrade RF, Terry GC, Montgomery RD, Curd D, Simmons DJ (1998) The effects of aggressive notchplasty on the normal knee in dogs. Am J Sports Med 26:193–200CrossRefPubMed
15.
LaPrade RF, Muench C, Wentorf F, Lewis JL (2002) The effect of injury to the posterolateral structures of the knee on force in a posterior cruciate ligament graft: a biomechanical study. Am J Sports Med 30:233–238PubMed
16.
LaPrade RF, Ly TV, Wentorf FA, Engebretsen L (2003) The posterolateral attachments of the knee: a qualitative and quantitative morphologic analysis of the fibular collateral ligament, popliteus tendon, popliteofibular ligament, and lateral gastrocnemius tendon. Am J Sports Med 31:854–860PubMed
17.
LaPrade RF, Johansen S, Wentorf FA, Engebretsen L, Esterberg JL, Tso A (2004) An analysis of an anatomical posterolateral knee reconstruction: an in vitro biomechanical study and development of a surgical technique. Am J Sports Med 32:1405–1414CrossRefPubMed
18.
Lee J, Papakonstantinou O, Brookenthal KR, Trudell D, Resnick DL (2003) Arcuate sign of posterolateral knee injuries: anatomic, radiographic, and MR imaging data related to patterns of injury. Skelet Radiol 32:619–627CrossRef
19.
Levy BA, Dajani KA, Morgan JA, Shah JP, Dahm DL, Stuart MJ (2010) Repair versus reconstruction of the fibular collateral ligament and posterolateral corner in the multiligament-injured knee. Am J Sports Med 38:804–809CrossRefPubMed
20.
McCarthy M, Camarda L, Wijicks CA, Johansen S, Engebretsten L, LaPrade RF (2010) Anatomic posterolateral knee reconstructions require a popliteofibular ligament reconstruction through a tibial tunnel. Am J Sports Med 38:1674–1681CrossRefPubMed
21.
McCarthy M, Ridley TJ, Bollier M, Wolf B, Cook S, Amendola A (2015) Posterolateral knee reconstruction versus repair. Iowa Orthop J 35:20–25PubMedPubMedCentral
22.
McKean D, Yoong P, Yanny S, Thomee E, Grant D, Teh JL, Mansour R (2015) The popliteal fibular ligament in acute knee trauma: patterns of injury on MR imaging. Skelet Radiol 44(10):1413–1419CrossRef
23.
Miyatake S, Kondo E, Tsai TY, Hirschman M, Halewood C, Jakobsen BW, Yasuda K, Amis AA (2011) Biomechanical comparisons between 4-strand and modified Larson 2-strand procedures for reconstruction of the posterolateral corner of the knee. Am J Sports Med 39:1462–1469CrossRefPubMed
24.
Osti M, Tschann P, Künzel KH, Benedetto KP (2013) Posterolateral corner of the knee: microsurgical analysis of anatomy and morphometry. Orthopedics 36:1114–1120CrossRef
25.
Panzica M, Janzik J, Bobrowitsch E, Krettek C, Hawi N, Hurschler C, Jagodzinski M (2015) Biomechanical comparison of two surgical techniques for press-fit reconstruction of the posterolateral complex of the knee. Arch Orthop Trauma Surg 135:1579–1588CrossRefPubMed
26.
Pietrini SD, LaPrade RF, Griffith CJ, Wijdicks CA, Ziegler CG (2009) Radiographic identification of the primary posterolateral knee structures. Am J Sports Med 37:542–551CrossRefPubMed
27.
Song GY, Zhang H, Zhang J, Li Y, Feng H (2015) Anatomical popliteofibular ligament reconstruction of the knee joints: an all-arthroscopic technique. Knee Surg Sports Traumatol Arthrosc 23:2925–2929CrossRefPubMed
28.
Stannard JP, Brown SL, Farris RC, McGwin G Jr, Volgas DA (2005) The posterolateral corner of the knee: repair versus reconstruction. Am J Sports Med 33:881–888CrossRefPubMed
29.
Tajima G, Nozaki M, Iriuchishima T, Ingham SJ, Shen W, Smolinski P, Fu FH (2009) Morphology of the tibial insertion of the posterior cruciate ligament. J Bone Joint Surg Am 91:859–866CrossRefPubMed
30.
Takeda S, Tajima G, Fujino K, Yan J, Kamei Y, Maruyama M, Kikuchi S, Doita M (2015) Morphology of the femoral insertion of the lateral collateral ligament and popliteus tendon. Knee Surg Sports Traumatol Arthrosc 23:3049–3054CrossRefPubMed
31.
Thaunat M, Pioger C, Chatellard R, Conteduca J, Khaleel A, Sonnery-Cottet B (2014) The arcuate ligament revisited: role of the posterolateral structures in providing static stability in the knee joint. Knee Surg Sports Traumatol Arthrosc 22:2121–2127CrossRefPubMed
32.
Terry GC, LaPrade RF (1996) The biceps femoris muscle complex at the knee. Its anatomy and injury patterns associated with acute anterolateral-anteromedial rotatory instability. Am J Sports Med 24:2–8CrossRefPubMed
33.
Tubbs RS, Caycedo FJ, Oakes WJ, Salter EG (2006) Descriptive anatomy of the insertion of the biceps femoris muscle. Clin Anat 19:517–521CrossRefPubMed
34.
Wechter JF, Bohm KC, Macalena JA, Sikka RS, Tompkins M (2015) Part II: the 50/60 fibular tunnel trajectory for posterolateral corner reconstruction in a cadaver model. Knee Surg Sports Traumatol Arthrosc 23:1895–1899CrossRefPubMed
35.
Yoon KH, Lee JH, Bae DK, Song SJ, Chung KY, Park YW (2011) Comparison of clinical results of anatomic posterolateral corner reconstruction for posterolateral rotatory instability of the knee with or without popliteal tendon reconstruction. Am J Sports Med 39:2421–2428CrossRefPubMed
Metadata
Title
Morphology of the fibular insertion of the posterolateral corner and biceps femoris tendon
Authors
Hirotaka Takahashi
Goro Tajima
Shuhei Kikuchi
Jun Yan
Yoichi Kamei
Moritaka Maruyama
Atsushi Sugawara
Takaaki Saigo
Minoru Doita
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4304-x

Other articles of this Issue 1/2017

Knee Surgery, Sports Traumatology, Arthroscopy 1/2017 Go to the issue

Knee

Development of a test battery to enhance safe return to sports after anterior cruciate ligament reconstruction

Knee

Direct versus indirect ACL femoral attachment fibres and their implications on ACL graft placement

Hip

Survey mode influence on patient-reported outcome scores in orthopaedic surgery: telephone results may be positively biased

Knee

Early full weight-bearing versus 6-week partial weight-bearing after open wedge high tibial osteotomy leads to earlier improvement of the clinical results: a prospective, randomised evaluation

Knee

Arthroscopic anatomic double-bundle ACL reconstruction using irradiated versus non-irradiated hamstring tendon allograft

Knee

Knee contact forces and lower extremity support moments during running in young individuals post-partial meniscectomy