Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2010

Open Access 01-12-2010 | Research article

Morphology of the medial collateral ligament of the knee

Authors: Fang Liu, Bing Yue, Hemanth R Gadikota, Michal Kozanek, Wanjun Liu, Thomas J Gill, Harry E Rubash, Guoan Li

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2010

Login to get access

Abstract

Background

Quantitative knowledge on the anatomy of the medial collateral ligament (MCL) is important for treatment of MCL injury and for MCL release during total knee arthroplasty (TKA). The objective of this study was to quantitatively determine the morphology of the MCL of human knees.

Methods

10 cadaveric human knees were dissected to investigate the MCL anatomy. The specimens were fixed in full extension and this position was maintained during the dissection and morphometric measurements. The outlines of the insertion sites of the superficial MCL (sMCL) and deep MCL (dMCL) were digitized using a 3D digitizing system.

Results

The insertion areas of the superficial MCL (sMCL) were 348.6 ± 42.8 mm2 and 79.7 ± 17.6 mm2 on the tibia and femur, respectively. The insertion areas of the deep MCL (dMCL) were 63.6 ± 13.4 mm2 and 71.9 ± 14.8 mm2 on the tibia and femur, respectively. The distances from the centroids of the tibial and femoral insertions of the sMCL to the tibial and femoral joint line were 62.4 ± 5.5 mm and 31.1 ± 4.6 mm, respectively. The distances from the centroids of dMCL in the tibial insertion and the femoral insertion to the tibial and femoral joint line were 6.5 ± 1.3 mm and 20.5 ± 4.2 mm, respectively. The distal portion of the dMCL (meniscotibial ligament - MTL) was approximately 1.7 times wider than the proximal portion of the dMCL (meniscofemoral ligament - MFL), whereas the MFL was approximately 3 times longer than the MTL.

Conclusions

The morphologic data on the MCL may provide useful information for improving treatments of MCL-related pathology and performing MCL release during TKA.
Appendix
Available only for authorised users
Literature
1.
go back to reference Robinson JR, Bull AM, Thomas RR, Amis AA: The role of the medial collateral ligament and posteromedial capsule in controlling knee laxity. Am J Sports Med. 2006, 34 (11): 1815-23. 10.1177/0363546506289433.CrossRefPubMed Robinson JR, Bull AM, Thomas RR, Amis AA: The role of the medial collateral ligament and posteromedial capsule in controlling knee laxity. Am J Sports Med. 2006, 34 (11): 1815-23. 10.1177/0363546506289433.CrossRefPubMed
2.
go back to reference Grood ES, Noyes FR, Butler DL, Suntay WJ: Ligamentous and capsular restraints preventing straight medial and lateral laxity in intact human cadaver knees. J Bone Joint Surg Am. 1981, 63 (8): 1257-69.PubMed Grood ES, Noyes FR, Butler DL, Suntay WJ: Ligamentous and capsular restraints preventing straight medial and lateral laxity in intact human cadaver knees. J Bone Joint Surg Am. 1981, 63 (8): 1257-69.PubMed
3.
go back to reference Ritter MA, Faris GW, Faris PM, Davis KE: Total knee arthroplasty in patients with angular varus or valgus deformities of 20?. The Journal of arthroplasty. 2004, 19 (7): 862-866. 10.1016/j.arth.2004.03.009.CrossRefPubMed Ritter MA, Faris GW, Faris PM, Davis KE: Total knee arthroplasty in patients with angular varus or valgus deformities of 20?. The Journal of arthroplasty. 2004, 19 (7): 862-866. 10.1016/j.arth.2004.03.009.CrossRefPubMed
4.
go back to reference Verdonk PC, Pernin J, Pinaroli A, Ait Si Selmi T, Neyret P: Soft tissue balancing in varus total knee arthroplasty: an algorithmic approach. Knee Surg Sports Traumatol Arthrosc. 2009, 17 (6): 660-6. 10.1007/s00167-009-0755-7.CrossRefPubMed Verdonk PC, Pernin J, Pinaroli A, Ait Si Selmi T, Neyret P: Soft tissue balancing in varus total knee arthroplasty: an algorithmic approach. Knee Surg Sports Traumatol Arthrosc. 2009, 17 (6): 660-6. 10.1007/s00167-009-0755-7.CrossRefPubMed
5.
go back to reference Engh GA: The difficult knee: severe varus and valgus. Clin Orthop Relat Res. 2003, 58-63. 10.1097/01.blo.0000092987.12414.fc. 416 Engh GA: The difficult knee: severe varus and valgus. Clin Orthop Relat Res. 2003, 58-63. 10.1097/01.blo.0000092987.12414.fc. 416
6.
go back to reference Yagishita K, Muneta T, Ikeda H: Step-by-step measurements of soft tissue balancing during total knee arthroplasty for patients with varus knees. J Arthroplasty. 2003, 18 (3): 313-20. 10.1054/arth.2003.50088.CrossRefPubMed Yagishita K, Muneta T, Ikeda H: Step-by-step measurements of soft tissue balancing during total knee arthroplasty for patients with varus knees. J Arthroplasty. 2003, 18 (3): 313-20. 10.1054/arth.2003.50088.CrossRefPubMed
7.
go back to reference De Maeseneer M, Van Roy F, Lenchik L, Barbaix E, De Ridder F, Osteaux M: Three layers of the medial capsular and supporting structures of the knee: MR imaging-anatomic correlation. Radiographics. 2000, 20 (Spec No): S83-9.CrossRefPubMed De Maeseneer M, Van Roy F, Lenchik L, Barbaix E, De Ridder F, Osteaux M: Three layers of the medial capsular and supporting structures of the knee: MR imaging-anatomic correlation. Radiographics. 2000, 20 (Spec No): S83-9.CrossRefPubMed
8.
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 (1): 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 (1): 56-62.PubMed
9.
go back to reference Robinson JR, Bull AM, Amis AA: Structural properties of the medial collateral ligament complex of the human knee. J Biomech. 2005, 38 (5): 1067-74. 10.1016/j.jbiomech.2004.05.034.CrossRefPubMed Robinson JR, Bull AM, Amis AA: Structural properties of the medial collateral ligament complex of the human knee. J Biomech. 2005, 38 (5): 1067-74. 10.1016/j.jbiomech.2004.05.034.CrossRefPubMed
10.
go back to reference Bartel DL, Marshall JL, Schieck RA, Wang JB: Surgical repositioning of the medial collateral ligament. An anatomical and mechanical analysis. J Bone Joint Surg Am. 1977, 59 (1): 107-16.PubMed Bartel DL, Marshall JL, Schieck RA, Wang JB: Surgical repositioning of the medial collateral ligament. An anatomical and mechanical analysis. J Bone Joint Surg Am. 1977, 59 (1): 107-16.PubMed
11.
go back to reference LaPrade RF, Engebretsen AH, Ly TV, Johansen S, Wentorf FA, Engebretsen L: The anatomy of the medial part of the knee. The Journal of Bone and Joint Surgery. 2007, 89 (9): 2000-10.2106/JBJS.F.01176.CrossRefPubMed LaPrade RF, Engebretsen AH, Ly TV, Johansen S, Wentorf FA, Engebretsen L: The anatomy of the medial part of the knee. The Journal of Bone and Joint Surgery. 2007, 89 (9): 2000-10.2106/JBJS.F.01176.CrossRefPubMed
12.
go back to reference Slocum DB, Larson RL: Rotatory instability of the knee. Its pathogenesis and a clinical test to demonstrate its presence. J Bone Joint Surg Am. 1968, 50 (2): 211-25.PubMed Slocum DB, Larson RL: Rotatory instability of the knee. Its pathogenesis and a clinical test to demonstrate its presence. J Bone Joint Surg Am. 1968, 50 (2): 211-25.PubMed
13.
go back to reference Last RJ: Some anatomical details of the knee joint. Journal of Bone & Joint Surgery, British Volume. 1948, 30 (4): 683-688. Last RJ: Some anatomical details of the knee joint. Journal of Bone & Joint Surgery, British Volume. 1948, 30 (4): 683-688.
14.
go back to reference Wijdicks CA, Griffith CJ, LaPrade RF, Johansen S, Sunderland A, Arendt EA, Engebretsen L: Radiographic identification of the primary medial knee structures. J Bone Joint Surg Am. 2009, 91 (3): 521-9. 10.2106/JBJS.H.00909.CrossRefPubMed Wijdicks CA, Griffith CJ, LaPrade RF, Johansen S, Sunderland A, Arendt EA, Engebretsen L: Radiographic identification of the primary medial knee structures. J Bone Joint Surg Am. 2009, 91 (3): 521-9. 10.2106/JBJS.H.00909.CrossRefPubMed
15.
go back to reference Abbott LRC, Saunders JB: Injuries to the ligaments of the knee joint. The Journal of Bone and Joint Surgery. 1944, 26 (3): 503- Abbott LRC, Saunders JB: Injuries to the ligaments of the knee joint. The Journal of Bone and Joint Surgery. 1944, 26 (3): 503-
16.
go back to reference Brantigan OC, Voshell AF: The tibial collateral ligament: its function, its bursae, and its relation to the medial meniscus. The Journal of Bone and Joint Surgery. 1943, 25 (1): 121- Brantigan OC, Voshell AF: The tibial collateral ligament: its function, its bursae, and its relation to the medial meniscus. The Journal of Bone and Joint Surgery. 1943, 25 (1): 121-
17.
go back to reference O'Donoghue DH: Surgical treatment of fresh injuries to the major ligaments of the knee. J Bone Joint Surg Am. 1950, 32 (A:4): 721-38.PubMed O'Donoghue DH: Surgical treatment of fresh injuries to the major ligaments of the knee. J Bone Joint Surg Am. 1950, 32 (A:4): 721-38.PubMed
18.
go back to reference Brantigan OC, Voshell AF: The mechanics of the ligaments and menisci of the knee joint. The Journal of Bone and Joint Surgery. 1941, 23 (1): 44- Brantigan OC, Voshell AF: The mechanics of the ligaments and menisci of the knee joint. The Journal of Bone and Joint Surgery. 1941, 23 (1): 44-
19.
go back to reference Sims WF, Jacobson KE: The posteromedial corner of the knee: medial-sided injury patterns revisited. Am J Sports Med. 2004, 32 (2): 337-45. 10.1177/0363546503261738.CrossRefPubMed Sims WF, Jacobson KE: The posteromedial corner of the knee: medial-sided injury patterns revisited. Am J Sports Med. 2004, 32 (2): 337-45. 10.1177/0363546503261738.CrossRefPubMed
20.
go back to reference Selvarajah E, Hooper G: Restoration of the joint line in total knee arthroplasty. J Arthroplasty. 2009, 24 (7): 1099-102. 10.1016/j.arth.2008.06.030.CrossRefPubMed Selvarajah E, Hooper G: Restoration of the joint line in total knee arthroplasty. J Arthroplasty. 2009, 24 (7): 1099-102. 10.1016/j.arth.2008.06.030.CrossRefPubMed
21.
go back to reference Griffith CJ, LaPrade RF, Johansen S, Armitage B, Wijdicks C, Engebretsen L: Medial knee injury: Part 1, static function of the individual components of the main medial knee structures. Am J Sports Med. 2009, 37 (9): 1762-70. 10.1177/0363546509333852.CrossRefPubMed Griffith CJ, LaPrade RF, Johansen S, Armitage B, Wijdicks C, Engebretsen L: Medial knee injury: Part 1, static function of the individual components of the main medial knee structures. Am J Sports Med. 2009, 37 (9): 1762-70. 10.1177/0363546509333852.CrossRefPubMed
Metadata
Title
Morphology of the medial collateral ligament of the knee
Authors
Fang Liu
Bing Yue
Hemanth R Gadikota
Michal Kozanek
Wanjun Liu
Thomas J Gill
Harry E Rubash
Guoan Li
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2010
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/1749-799X-5-69

Other articles of this Issue 1/2010

Journal of Orthopaedic Surgery and Research 1/2010 Go to the issue