Skip to main content
Top
Published in: Skeletal Radiology 8/2003

01-08-2003 | Review Article

The distal semimembranosus complex: normal MR anatomy, variants, biomechanics and pathology

Authors: Javier Beltran, Amir Matityahu, Ki Hwang, Marlena Jbara, Ron Maimon, Mario Padron, Javier Mota, Luis Beltran, Murali Sundaram

Published in: Skeletal Radiology | Issue 8/2003

Login to get access

Abstract

Objective

To describe the normal MR anatomy and variations of the distal semimembranosus tendinous arms and the posterior oblique ligament as seen in the three orthogonal planes, to review the biomechanics of this complex and to illustrate pathologic examples.

Results and conclusion

The distal semimembranosus tendon divides into five tendinous arms named the anterior, direct, capsular, inferior and the oblique popliteal ligament. These arms intertwine with the branches of the posterior oblique ligament in the posterior medial aspect of the knee, providing stability. This tendon-ligamentous complex also acts synergistically with the popliteus muscle and actively pulls the posterior horn of the medial meniscus during knee flexion. Pathologic conditions involving this complex include complete and partial tears, insertional tendinosis, avulsion fractures and bursitis.
Literature
1.
go back to reference Kaplan EB. Some aspects of functional anatomy of the human knee joint. Clin Orthop 1962; 23:18–29. Kaplan EB. Some aspects of functional anatomy of the human knee joint. Clin Orthop 1962; 23:18–29.
2.
go back to reference Hughston JC, Eilers AF. The role of the posterior oblique ligament in repairs of acute medial (collateral) ligament tears of the knee. J Bone Joint Surg Am 1973; 55:923–940.PubMed Hughston JC, Eilers AF. The role of the posterior oblique ligament in repairs of acute medial (collateral) ligament tears of the knee. J Bone Joint Surg Am 1973; 55:923–940.PubMed
3.
go back to reference Hassine D, Rougereau G, Feron JM, Henry-Feugeas MC, Fabre V, et al. MR imaging of posteromedial and posterolateral stabilizers of the knee: anatomic basis and patterns of lesions in knee injuries. Surg Radiol Anat 1994; 16:293–301.PubMed Hassine D, Rougereau G, Feron JM, Henry-Feugeas MC, Fabre V, et al. MR imaging of posteromedial and posterolateral stabilizers of the knee: anatomic basis and patterns of lesions in knee injuries. Surg Radiol Anat 1994; 16:293–301.PubMed
4.
go back to reference Loredo R, Hodler J, Pedowitz R, Yeh LR, Trudell D, Resnick D. Posteromedial corner of the knee: MR imaging with gross anatomic correlation. Skeletal Radiol 1999; 28:305–311.CrossRefPubMed Loredo R, Hodler J, Pedowitz R, Yeh LR, Trudell D, Resnick D. Posteromedial corner of the knee: MR imaging with gross anatomic correlation. Skeletal Radiol 1999; 28:305–311.CrossRefPubMed
5.
go back to reference Warren LF, Marshall JL. The supporting structures and layers on the medial side of the knee: an anatomical analysis. J Bone Joint Surg Am 1979; 61:56–62.PubMed Warren LF, Marshall JL. The supporting structures and layers on the medial side of the knee: an anatomical analysis. J Bone Joint Surg Am 1979; 61:56–62.PubMed
6.
go back to reference Hughston JC. Knee ligaments. Injury and repair. St Louis: Mosby, 1993:3–70. Hughston JC. Knee ligaments. Injury and repair. St Louis: Mosby, 1993:3–70.
7.
go back to reference Kim YC, Yoo WK, Chung IH, Seo JS, Tanaka S. Tendinous insertion of semimembranosus muscle into the lateral meniscus. Surg Radiol Anat 1997; 19:365–369.PubMed Kim YC, Yoo WK, Chung IH, Seo JS, Tanaka S. Tendinous insertion of semimembranosus muscle into the lateral meniscus. Surg Radiol Anat 1997; 19:365–369.PubMed
8.
go back to reference Hughston JC. The importance of the posterior oblique ligament in repairs of acute tears of the medial ligaments in knees with and without an associated rupture of the anterior cruciate ligament. J Bone Joint Surg Am 1994; 76:1328–1344.PubMed Hughston JC. The importance of the posterior oblique ligament in repairs of acute tears of the medial ligaments in knees with and without an associated rupture of the anterior cruciate ligament. J Bone Joint Surg Am 1994; 76:1328–1344.PubMed
9.
go back to reference Brantigan OC, Voshell AF. The tibial collateral ligament: its function, its bursae, and its relation to the medial meniscus. J Bone Joint Surg 1943; 25:121–131. Brantigan OC, Voshell AF. The tibial collateral ligament: its function, its bursae, and its relation to the medial meniscus. J Bone Joint Surg 1943; 25:121–131.
10.
go back to reference Brantigan OC, Voshell AF. The mechanics of the ligaments and menisci of the knee joint. J Bone Joint Surg 1941; 23:44–66. Brantigan OC, Voshell AF. The mechanics of the ligaments and menisci of the knee joint. J Bone Joint Surg 1941; 23:44–66.
11.
go back to reference Renstrom P, Johnson RJ. Anatomy and biomechanics of the menisci. Clin Sports Med 1990; 9:523–538. Renstrom P, Johnson RJ. Anatomy and biomechanics of the menisci. Clin Sports Med 1990; 9:523–538.
12.
go back to reference Torreggiani WC, Al-Ismail K, Munk PL, Roche C, Keogh C, Nicolau S, Marchinkow LP. The imaging spectrum of Baker's (popliteal) cysts. Clin Radiol 2002; 57:681–691.CrossRefPubMed Torreggiani WC, Al-Ismail K, Munk PL, Roche C, Keogh C, Nicolau S, Marchinkow LP. The imaging spectrum of Baker's (popliteal) cysts. Clin Radiol 2002; 57:681–691.CrossRefPubMed
13.
go back to reference Rothstein CP, Laorr A, Helms CA, Tirman P. Semimembranosus-tibial collateral ligament bursitis: MR findings. AJR Am J Roentgenol 1996; 166:875–877.PubMed Rothstein CP, Laorr A, Helms CA, Tirman P. Semimembranosus-tibial collateral ligament bursitis: MR findings. AJR Am J Roentgenol 1996; 166:875–877.PubMed
14.
go back to reference Varela JR, Rodriguez E, Soler R, Gonzalez J, Pombo S. Complete rupture of the distal semimembranosus tendon with secondary hamstring muscles atrophy: MR findings in two cases. Skeletal Radiol 2000; 29:362–364.CrossRefPubMed Varela JR, Rodriguez E, Soler R, Gonzalez J, Pombo S. Complete rupture of the distal semimembranosus tendon with secondary hamstring muscles atrophy: MR findings in two cases. Skeletal Radiol 2000; 29:362–364.CrossRefPubMed
15.
go back to reference Alioto RJ, Browne JE, Barnthouse CD, Scott AR. Complete rupture of the distal semimembranosus complex in a professional athlete. Clin Orthop Rel Res 1997; 336:162–165. Alioto RJ, Browne JE, Barnthouse CD, Scott AR. Complete rupture of the distal semimembranosus complex in a professional athlete. Clin Orthop Rel Res 1997; 336:162–165.
16.
go back to reference DeSmet AA, Best TM. MR imaging of the distribution and location of acute hamstring injuries in athletes. AJR Am J Roentgenol 2000; 174:393–399.PubMed DeSmet AA, Best TM. MR imaging of the distribution and location of acute hamstring injuries in athletes. AJR Am J Roentgenol 2000; 174:393–399.PubMed
17.
go back to reference Yao L, Lee JK. Avulsion of the posteromedial tibial plateau by the semimembranosus tendon: diagnosis with MR imaging. Radiology 1989; 172:513–514.PubMed Yao L, Lee JK. Avulsion of the posteromedial tibial plateau by the semimembranosus tendon: diagnosis with MR imaging. Radiology 1989; 172:513–514.PubMed
18.
go back to reference Chan KK, Resnick D, Goodwin D, Seeger LL. Posteromedial tibial plateau injury including avulsion fracture of the semimembranosus tendon insertion site: ancillary sign of anterior cruciate ligament tear at MR imaging. Radiology 1999; 211:754–758.PubMed Chan KK, Resnick D, Goodwin D, Seeger LL. Posteromedial tibial plateau injury including avulsion fracture of the semimembranosus tendon insertion site: ancillary sign of anterior cruciate ligament tear at MR imaging. Radiology 1999; 211:754–758.PubMed
19.
go back to reference Bencardino JT, Rosenberg ZS, Brown R, Hassakhani A, Lustrin E, Beltran J. Traumatic musculotendinous injuries of the knee: diagnosis with MR imaging. RadioGraphics 2000; 20:S103-S120.PubMed Bencardino JT, Rosenberg ZS, Brown R, Hassakhani A, Lustrin E, Beltran J. Traumatic musculotendinous injuries of the knee: diagnosis with MR imaging. RadioGraphics 2000; 20:S103-S120.PubMed
20.
go back to reference Vanek J. Posteromedial fracture of the tibial plateau is not an avulsion injury. A case report and experimental study. J Bone Joint Surg 1994; 76:290–292. Vanek J. Posteromedial fracture of the tibial plateau is not an avulsion injury. A case report and experimental study. J Bone Joint Surg 1994; 76:290–292.
21.
go back to reference Andersen-Ranberg F, Hejgaard N. Ruptured semimembranosus bursa: an unusual complication following sports injury of the knee. J Sports Med 1986; 20:23–24. Andersen-Ranberg F, Hejgaard N. Ruptured semimembranosus bursa: an unusual complication following sports injury of the knee. J Sports Med 1986; 20:23–24.
22.
go back to reference Bunker TD, Thomas E. Ruptured semimembranosus bursa: a complication of arthroscopy. A short case report. Injury 1983; 15:182–183.PubMed Bunker TD, Thomas E. Ruptured semimembranosus bursa: a complication of arthroscopy. A short case report. Injury 1983; 15:182–183.PubMed
Metadata
Title
The distal semimembranosus complex: normal MR anatomy, variants, biomechanics and pathology
Authors
Javier Beltran
Amir Matityahu
Ki Hwang
Marlena Jbara
Ron Maimon
Mario Padron
Javier Mota
Luis Beltran
Murali Sundaram
Publication date
01-08-2003
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 8/2003
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-003-0641-1

Other articles of this Issue 8/2003

Skeletal Radiology 8/2003 Go to the issue